Life and death decisions for incompetent patients: determining best interests--the Irish perspective.
AffiliationDepartment of Neonatology, Cork University Maternity Hospital, Cork, Ireland.
Aged, 80 and over
Attitude of Health Personnel
Life Support Care
Physician's Practice Patterns
MetadataShow full item record
CitationLife and death decisions for incompetent patients: determining best interests--the Irish perspective. 2011, 100 (4):519-23 Acta Paediatr.
JournalActa paediatrica (Oslo, Norway : 1992)
AbstractTo determine whether healthcare providers apply the best interest principle equally to different resuscitation decisions.
An anonymous questionnaire was distributed to consultants, trainees in neonatology, paediatrics, obstetrics and 4th medical students. It examined resuscitation scenarios of critically ill patients all needing immediate resuscitation. Outcomes were described including survival and potential long-term sequelae. Respondents were asked whether they would intubate, whether resuscitation was in the patients best interest, would they accept surrogate refusal to initiate resuscitation and in what order they would resuscitate.
The response rate was 74%. The majority would wish resuscitation for all except the 80-year-old. It was in the best interest of the 2-month-old and the 7-year-old to be resuscitated compared to the remaining scenarios (p value <0.05 for each comparison). Approximately one quarter who believed it was in a patient best interests to be resuscitated would nonetheless accept the family refusing resuscitation. Medical students were statistically more likely to advocate resuscitation in each category.
These results suggest resuscitation is not solely related to survival or long-term outcome and the best interest principle is applied differently, more so at the beginning of life.
- Ethics of resuscitation at different stages of life: a survey of perinatal physicians.
- Authors: Laventhal N, Spelke MB, Andrews B, Larkin LK, Meadow W, Janvier A
- Issue date: 2011 May
- Baby doe redux? The Department of Health and Human Services and the Born-Alive Infants Protection Act of 2002: a cautionary note on normative neonatal practice.
- Authors: Sayeed SA
- Issue date: 2005 Oct
- Attitudes and preferences of intensivists regarding the role of family interests in medical decision making for incompetent patients.
- Authors: Hardart GE, Truog RD
- Issue date: 2003 Jul
- Intensive care for very low birthweight infants in South Africa: a survey of physician attitudes, parent counseling and resuscitation practices.
- Authors: Partridge JC, Ranchod TM, Ballot DE, Martinez AM, Cory BJ, Davies VA
- Issue date: 2005 Feb
- Physician counselling practices and decision-making for extremely preterm infants in the Pacific Rim.
- Authors: Martinez AM, Partridge JC, Yu V, Wee Tan K, Yeung CY, Lu JH, Nishida H, Boo NY
- Issue date: 2005 Apr