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Care of terminally-ill patients: an opinion survey among critical care healthcare providers in the Middle East
Open accessAbstract
BACKGROUND: Modern medicine has allowed physicians to support the dying terminally-ill patient with artificial means. However, a common dilemma faced by physicians in general, and intensivist in particular is when to limit or withdraw aggressive intervention. OBJECTIVE: To study the effect of training background and seniority on Do-not to resuscitate (DNR) decisions in the Middle East. METHODS: Anonymous questionnaire sent to members of the Pan Arab Society of Critical Care. RESULTS: The response rate was 46.2%. Most of the responders were Muslim (86%) and consultants (70.9%). Majority of the responders were trained in western countries. Religion played a major role in 59.3% for making the DNR decision. DNR was considered equivalent to comfort care by 39.5%. In a futile case scenario, Do Not Escalate Therapy was preferred (54.7%). The likelihood of a patient, once labeled DNR, being clinically neglected was a concern among 46.5%. Admission of DNR patients to the ICU was acceptable for 47.7%. Almost one-half of the responders (46.5%) wanted physicians to have the ultimate authority in the DNR decision. Training background was a significant factor affecting the interpretation of the term no code DNR (P< 0.008). CONCLUSION: Training background and level of seniority in critical care provider does not impact opinion on most of end of life issues related to care of terminally-ill patients. However, DNR is considered equivalent to comfort care among majority of Middle Eastern trained physicians.
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In the citing paper
“Typically, end-of-life issues were identified as being discussed prior to becoming severely ill,31 being informed of a poor prognosis and/or referred for palliative care,32 having 4–6 months to live,33 disease progressed to terminal stage,34 last week of life,35 health deteriorated,3639 person moving to a residential setting,39 at a care plan meeting39 and inpatient discharge.38”
From Do not attempt cardiopulmonary resuscitation decision-making process: scoping review (2025) · cites this paper as [31]
In the citing paper
“Religion plays a role in making DNR decisions for 58.3%31 and the importance of comfort during dying was a priority for 45.3%.31”
From Do not attempt cardiopulmonary resuscitation decision-making process: scoping review (2025) · cites this paper as [31]
In the citing paper
“Training and background of healthcare professionals were significant factors affecting the interpretation of the term no code DNACPR.31”
From Do not attempt cardiopulmonary resuscitation decision-making process: scoping review (2025) · cites this paper as [31]
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Do not attempt cardiopulmonary resuscitation decision-making process: scoping review
Doody, O., Davidson, H., & Lombard, J. (2025) · BMJ Supportive & Palliative Care · doi:10.1136/spcare-2023-004573 · Cited by 10
“Typically, end- of-life issues were identified as being discussed prior to becoming severely ill, 31 being informed of a poor prognosis and/or referred for palliative care, 32 having 4–6 months to live, 33 disease progressed to terminal stage, 34 last week of life, 35 health deteriorated, 36–39…”
BackgroundAlwazzeh, M. J., Aljoudi, A. S., Subbarayalu, A. V., Alharbi, A. F., Aldowayan, A. K., Alshahrani, S. F., Alamri, A. M., & Almuhanna, F. A. (2023) · Electronic Journal of General Medicine · doi:10.29333/ejgm/12901 · Cited by 3
Metadata
- Authors
- Ur Rahman, M., Abuhasna, S., & Abu-Zidan, F.
- Affiliations
- Tawam Hospital (AE)
- Venue
- African Health Sciences
- Publisher
- African Journals Online (AJOL)
- Published
- 2014-01-27
- Volume
- 13
- Issue
- 4
- Pages
- 893
- ISSN
- 1680-6905 (ISSN-L)
- PMC
- PMC4056474
- OpenAlex
- W2015518756
- Cited by
- 29
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 1
- FWCI
- 2.32
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- African Health Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Keywords
- do-not-resuscitate orders, end-of-life care, dying patients, intensivists, physician attitudes, training background, comfort care, Middle East
- MeSH terms
- Attitude of Health Personnel, Critical Care, Decision Making, Female, Health Personnel, Humans, Male, Middle Aged, Middle East, Surveys and Questionnaires, Resuscitation Orders, Terminally Ill, Health Care Surveys
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