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Cited by 15Palliative Care and End-of-Life IssuesEthics in medical practiceEthics and bioethics in healthcare

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Are physicians on the same page about do-not-resuscitate? To examine individual physicians’ influence on do-not-resuscitate decision-making: a retrospective and observational study

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Chen, Yen-Yuan, Su, Melany, Huang, Shu-Chien, Chu, Tzong-Shinn, Lin, Ming-Tsan, Chiu, Yu-Chun, Lin, Kuan-Han·2019·BMC Medical Ethics
DOI 10.1186/s12910-019-0429-zPMC PMC6894148
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Abstract

Background: Individual physicians and physician-associated factors may influence patients’/surrogates’ autonomous decision-making, thus influencing the practice of do-not-resuscitate (DNR) orders. The objective of this study was to examine the influence of individual attending physicians on signing a DNR order. Methods: This study was conducted in closed model, surgical intensive care units in a university-affiliated teaching hospital located in Northern Taiwan. The medical records of patients, admitted to the surgical intensive care units for the first time between June 1, 2011 and December 31, 2013 were reviewed and data collected. We used Kaplan–Meier survival curves with log-rank test and multivariate Cox proportional hazards models to compare the time from surgical intensive care unit admission to do-not-resuscitate orders written for patients for each individual physician. The outcome variable was the time from surgical ICU admission to signing a DNR order. Results: We found that each individual attending physician’s likelihood of signing do-not-resuscitate orders for their patients was significantly different from each other. Some attending physicians were more likely to write do-not-resuscitate orders for their patients, and other attending physicians were less likely to do so. Conclusion: Our study reported that individual attending physicians had influence on patients’/surrogates’ do-not-resuscitate decision-making. Future studies may be focused on examining the reasons associated with the difference of each individual physician in the likelihood of signing a do-not-resuscitate order.

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Metadata

Authors
Chen, Y.-Y., Su, M., Huang, S.-C., Chu, T.-S., Lin, M.-T., Chiu, Y.-C., & Lin, K.-H.
Affiliations
  • National Taiwan University (TW)
  • New York University (US)
  • National Taiwan University Hospital (TW)
  • Asia University (TW)
Corresponding author
  • Chiu, Yu-Chun
  • Lin, Kuan-Han
ORCID
Venue
BMC Medical Ethics
Publisher
Springer Science and Business Media LLC
Published
2019-12
Volume
20
Issue
1
Pages
92-92
ISSN
1472-6939 (ISSN-L)
DOI
10.1186/s12910-019-0429-z
PMC
PMC6894148
OpenAlex
W2992983747
Cited by
15
References
0
Citations by year
2026: 1 · 2025: 5 · 2024: 2 · 2023: 3 · 2021: 3 · 2020: 1
FWCI
0.92
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Medical Ethics (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Ministry of Science and Technology, Taiwan (MOST 103-2511-S-002-008-MY5, MOST 108-2634-F-002-023)
  • National Taiwan University Hospital (105-N3316)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
Keywords
do-not-resuscitate orders, attending physicians, surgical intensive care unit, physician practice variation, surrogate decision-making, patient autonomy
MeSH terms
Adult, Age Factors, Aged, Aged, 80 and over, Decision Making, Female, Hospitals, University, Humans, Intensive Care Units, Male, Middle Aged, Practice Patterns, Physicians', Physician's Role, Physicians, Retrospective Studies, Sex Factors, Socioeconomic Factors, Taiwan, Time Factors, Proportional Hazards Models, Resuscitation Orders, Kaplan-Meier Estimate

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