The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.
Increasing incidence of withholding and withdrawal of life support from the critically ill.
Abstract
To determine whether limits to life-sustaining care are becoming more common, we attempted to quantify the incidence of recommendations to withhold or withdraw life support from critically ill patients, to describe how patients respond to these recommendations, and to examine how conflicts over these recommendations are resolved. In 1992 and 1993 we prospectively enrolled 179 consecutive patients from two intensive care units (ICUs) for whom a recommendation was made to withhold or withdraw life support. Where possible, we compared results with data collected in the same units over a similar time period in 1987 and 1988. Recommendations to withhold or withdraw life support preceded 179 of 200 deaths (90%) in 1992 and 1993, compared with 114 of 224 deaths (51%) in 1987 and 1988 (chi2 = 73.76, p < 0.001]. Cardiopulmonary resuscitation was initiated in 10% of deaths in 1992 and 1993 as compared with 49% in 1987 and 1988. Ninety percent of patients agreed within less than 5 d, and only eight patients (4%) refused physicians' recommendations to limit life support. In cases of conflict, physicians in 1992 and 1993 deferred to patients with one exception: physicians were willing to refuse surrogate requests for resuscitation of patients they considered hopelessly ill. We conclude that 90% of patients who die in these ICUs now do so following a decision to limit therapy, that this represents a major change in practice in these institutions over a period of 5 yr, that most patients and surrogates accept an appropriate recommendation to withhold or withdraw life support, and that physicians will refuse surrogate requests in certain circumstances.
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Cites
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Medical Futility: Its Meaning and Ethical Implications
Schneiderman, L. J., Jecker, N. S., & Jonsen, A. R. (1990) · Annals of Internal Medicine · doi:10.7326/0003-4819-112-12-949 · Cited by 1,215
Withholding and Withdrawal of Life Support from the Critically Ill
Smedira, N. G., Evans, B. H., Grais, L. S., Cohen, N. H., Lo, B., Cooke, M., Schecter, W. P., Fink, C., Epstein-Jaffe, E., May, C., et al. (1990) · New England Journal of Medicine · doi:10.1056/nejm199002013220506 · Cited by 613
Self-citationThe Physician's Responsibility toward Hopelessly Ill Patients
Wanzer, S. H., Federman, D. D., Adelstein, S. J., Cassel, C. K., Cassem, E. H., Cranford, R. E., Hook, E. W., Lo, B., Moertel, C. G., Safar, P., et al. (1989) · New England Journal of Medicine · doi:10.1056/nejm198903303201306 · Cited by 434
Initiating and Withdrawing Life Support
Ruark, J. E., Raffin, T. A., & The Stanford University Medical Center Committee on Ethics* (1988) · New England Journal of Medicine · doi:10.1056/nejm198801073180106 · Cited by 280
Guidelines on the Termination of Life-Sustaining Treatment and the Care of the Dying
Applebaum, R., Anderson, J. R., Sachs, G., & Miles, S. H. (1988) · The Gerontologist · doi:10.1093/geront/28.6.847 · Cited by 256
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How well is the patient self-determination act working?: An early assessment
Emanuel, E. J., Weinberg, D. S., Gonin, R., Hummel, L. R., & Emanuel, L. L. (1993) · The American Journal of Medicine · doi:10.1016/0002-9343(93)90358-v · Cited by 127
The Physician's Obligation to Prolong Life: A Medical Duty without Classical Roots
Amundsen, D. W. (1978) · The Hastings Center Report · doi:10.2307/3560974 · Cited by 123
Cited by
Weaning from mechanical ventilation
Boles, J.-M., Bion, J., Connors, A., Herridge, M., Marsh, B., Melot, C., Pearl, R., Silverman, H., Stanchina, M., Vieillard-Baron, A., et al. (2007) · European Respiratory Journal · doi:10.1183/09031936.00010206 · Cited by 2,064
Zimmerman, J. E., Kramer, A. A., McNair, D. S., & Malila, F. M. (2006) · Critical Care Medicine · doi:10.1097/01.ccm.0000215112.84523.f0 · Cited by 1,764
Use of intensive care at the end of life in the United States: An epidemiologic study*
Angus, D. C., Barnato, A. E., Linde-Zwirble, W. T., Weissfeld, L. A., Watson, R. S., Rickert, T., & Rubenfeld, G. D. (2004) · Critical Care Medicine · doi:10.1097/01.ccm.0000114816.62331.08 · Cited by 1,155
Nates, J. L., Nunnally, M., Kleinpell, R., Blosser, S., Goldner, J., Birriel, B., Fowler, C. S., Byrum, D., Miles, W. S., Bailey, H., et al. (2016) · Critical Care Medicine · doi:10.1097/ccm.0000000000001856 · Cited by 683
The Inner Life of Physicians and Care of the Seriously Ill
Meier, D. E. (2001) · JAMA · doi:10.1001/jama.286.23.3007 · Cited by 675
Metadata
- Authors
- Prendergast, T. J., & Luce, J. M.
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 1997-01
- Volume
- 155
- Issue
- 1
- Pages
- 15-20
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2059270934
- Cited by
- 730
- References
- 18
- FWCI
- 38.63
- Type
- journal article
- Language
- en
- Open access
- closed
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- Prendergast, T. J., & Luce, J. M. (1997). Increasing incidence of withholding and withdrawal of life support from the critically ill. American Journal of Respiratory and Critical Care Medicine. https://doi.org/10.1164/ajrccm.155.1.9001282
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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