Evidence map›Paper›PMID 39138443›Full record

ArticleBMC palliative care2024

Physicians' experiences and perceptions about withholding and withdrawal life-sustaining treatment in Chiang Mai University Hospital: a cross-sectional study.

Nattanit Ketchaikosol, Kanokporn Pinyopornpanish, Chaisiri Angkurawaranon, Nisachol Dejkriengkraikul, Lalita Chutarattanakul

Abstract read
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Article in BMC palliative care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Nattanit KetchaikosolDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd. Si Phum, Muang, Chiang Mai, Chiang Mai, 50200, Thailand.
Kanokporn PinyopornpanishDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd. Si Phum, Muang, Chiang Mai, Chiang Mai, 50200, Thailand.
Chaisiri AngkurawaranonDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd. Si Phum, Muang, Chiang Mai, Chiang Mai, 50200, Thailand.
Nisachol DejkriengkraikulDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd. Si Phum, Muang, Chiang Mai, Chiang Mai, 50200, Thailand.
Lalita ChutarattanakulDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd. Si Phum, Muang, Chiang Mai, Chiang Mai, 50200, Thailand. lalitachuta.fm@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWithholding or withdrawing life-sustaining treatment in end-of-life patients is a challenging ethical issue faced by physicians. Understanding physicians' experiences and factors influencing their decisions can lead to improvement in end-of-life care.

objectivesTo investigate the experiences of Thai physicians when making decisions regarding the withholding or withdrawal of life-sustaining treatments in end-of-life situations. Additionally, the study aims to assess the consensus among physicians regarding the factors that influence these decisions and to explore the influence of families or surrogates on the decision-making process of physicians, utilizing case-based surveys.

methodsA web-based survey was conducted among physicians practicing in Chiang Mai University Hospital (June - October 2022).

resultsAmong 251 physicians (response rate 38.3%), most of the respondents (60.6%) reported that they experienced withholding or withdrawal treatment in end-of-life patients. Factors that influence their decision-making include patient's preferences (100%), prognosis (93.4%), patients' quality of life (92.8%), treatment burden (89.5%), and families' request (87.5%). For a chronic disease with comatose condition, the majority of the physicians (47%) chose to continue treatments, including cardiopulmonary resuscitation (CPR). In contrast, only 2 physicians (0.8%) would do everything, in cases when families or surrogates insisted on stopping the treatment. This increased to 78.1% if the families insisted on continuing treatment.

conclusionWithholding and withdrawal of life-sustaining treatments are common in Thailand. The key factors influencing their decision-making process included patient's preferences and medical conditions and families' requests. Effective communication and early engagement in advanced care planning between physicians, patients, and families empower them to align treatment choices with personal values.

Indexed as

Hospitals, UniversityPhysiciansWithholding TreatmentAdultAttitude of Health PersonnelCross-Sectional StudiesDecision MakingFemaleHumansLife Support CareMaleMiddle AgedPerceptionSurveys and QuestionnairesTerminal CareThailandDecision makingEnd of life carePalliative carePhysician experiencePractical experienceWithdrawal life-sustaining treatmentWithholding life-sustaining treatment

Identifiers

PMID39138443
PMCPMC11320918

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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.