ArticleIntensive care medicine2012
Association between education in EOL care and variability in EOL practice: a survey of ICU physicians.
Article in Intensive care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 78 citations in OpenAlex.
- Impact of nonclinical factors on intensive care unit admission decisions: a vignette-based randomized trial (V-TRIAGE).Revista Brasileira de terapia intensivaTrial
- Observational Study on Enhancing End-of-Life Care Competence Through OSCE: Educational Implications.Medical science educator · 2025Article
- Physicians' experiences and perceptions about withholding and withdrawal life-sustaining treatment in Chiang Mai University Hospital: a cross-sectional study.BMC palliative care · 2024Article
- Review
- Relationship between characteristics of health professionals and the respect for the autonomy of cancer patients at the end of life.PloS one · 2024Article
- Variability in the perception of palliative care and end-of-life care among hematology professionals from the same reference center in Bahia, Brazil: A descriptive cross-sectional study.Sao Paulo medical journal = Revista paulista de medicina · 2024Article
- Limiting life-sustaining treatment for very old ICU patients: cultural challenges and diverse practices.Annals of intensive care · 2023Article
- Cognitive biases and moral characteristics of healthcare workers and their treatment approach for persons with advanced dementia in acute care settings.Frontiers in medicine · 2023Article
- Palliative extubation experience in a community hospital in southern Brazil.Revista da Associacao Medica Brasileira (1992) · 2023Article
- Limitation of Futile Therapy in the Opinion of Nursing Staff Employed in Polish Hospitals-Results of a Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- End-of-Life Decision-Making in Pediatric and Neonatal Intensive Care Units in Croatia-A Focus Group Study among Nurses and Physicians.Medicina (Kaunas, Lithuania) · 2022Article
- Physicians' decreased tendency to choose palliative care for patients with advanced dementia between 1999 and 2015.BMC palliative care · 2021Article
- Postcardiac Arrest Neuroprognostication Practices: A Survey of Brazilian Physicians.Critical care explorations · 2021Article
- The ethics of DNR-decisions in oncology and hematology care: a qualitative study.BMC medical ethics · 2020Article
- Variables that influence the medical decision regarding Advance Directives and their impact on end-of-life care.Einstein (Sao Paulo, Brazil) · 2020Review
- Does special education in palliative medicine make a difference in end-of-life decision-making?BMC palliative care · 2018Article
- Physician-related determinants of medical end-of-life decisions - A mortality follow-back study in Switzerland.PloS one · 2018Article
- Observational
- Do not attempt resuscitation order in Japan.Acute medicine & surgery · 2017Article
- The effects of performance status one week before hospital admission on the outcomes of critically ill patients.Intensive care medicine · 2017Article
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study investigated the association between physician education in EOL and variability in EOL practice, as well as the differences between beliefs and practices regarding EOL in the ICU.
methodsPhysicians from 11 ICUs at a university hospital completed a survey presenting a patient in a vegetative state with no family or advance directives. Questions addressed approaches to EOL care, as well physicians' personal, professional and EOL educational characteristics.
resultsThe response rate was 89%, with 105 questionnaires analyzed. Mean age was 38 ± 8 years, with a mean of 14 ± 7 years since graduation. Physicians who did not apply do-not-resuscitate (DNR) orders were less likely to have attended EOL classes than those who applied written DNR orders [0/7 vs. 31/47, OR = 0.549 (0.356-0.848), P = 0.001]. Physicians who involved nurses in the decision-making process were more likely to be ICU specialists [17/22 vs. 46/83, OR = 4.1959 (1.271-13.845), P = 0.013] than physicians who made such decisions among themselves or referred to ethical or judicial committees. Physicians who would apply "full code" had less often read about EOL [3/22 vs. 11/20, OR = 0.0939 (0.012-0.710), P = 0.012] and had less interest in discussing EOL [17/22 vs. 20/20, OR = 0.210 (0.122-0.361), P < 0.001], than physicians who would withdraw life-sustaining therapies. Forty-four percent of respondents would not do what they believed was best for their patient, with 98% of them believing a less aggressive attitude preferable. Legal concerns were the leading cause for this dichotomy.
conclusionsPhysician education about EOL is associated with variability in EOL decisions in the ICU. Moreover, actual practice may differ from what physicians believe is best for the patient.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.