Evidence map›Paper›PMID 40616083›Full record

ArticleBMC medical ethics2025

Preferences for life-sustaining treatments in advance decisions: a cross-sectional survey of Taiwanese general public.

Daniel Fu-Chang Tsai, Yu-Chen Juang, Chun-Tung Kuo, Ping-Hsueh Lee, Duan-Rung Chen

Abstract read
In one paragraph

Article in BMC medical ethics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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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

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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

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0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Daniel Fu-Chang TsaiDepartment & Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University, Taipei, Taiwan.
Yu-Chen JuangDepartment & Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University, Taipei, Taiwan.
Chun-Tung KuoInstitute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
Ping-Hsueh LeeDepartment of Geriatrics Medicine, Kuang Tien General Hospital, Taichung, Taiwan.
Duan-Rung ChenInstitute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan. duan@ntu.edu.tw.

Funding

Ministry of Education NTU-114L900401National Science and Technology Council 109-2511-H-002-016-MY3National Science and Technology Council 113-2410-H-002-067-SS2National Taiwan University Hospital NTUH.108-S4390
6 · The paper itself

Abstract

backgroundTaiwan passed the Patient Right to Autonomy Act in 2016 and introduced a legal document called advance decision to address dilemmas in making life-sustaining treatment (LST) decisions for incompetent patients. However, the proportion of Taiwanese adults who have completed an advance decision remains low, and public preference trends are unclear.

methodsA cross-sectional telephone survey was conducted among Taiwanese adults using a structured questionnaire to assess preferences regarding five types of LSTs across four hypothetical clinical scenarios (late-stage motor neuron disease, severe dementia, irreversible coma, and terminal cancer). Participants were categorized based on their preference patterns, and factors associated with each subgroup were analyzed.

resultsOf the 3188 individuals contacted, 2440 declined to participate, and 748 (24.3%) respondents were successfully interviewed. A total of 747 responses were included in the analysis. Latent class analysis identified four preference subgroups: pro-forgo (more than half of the respondents), neutral, aggressive, and motor-neuron-disease specific. Older age, higher education, and better quality of life were associated with a greater likelihood of belonging to the pro-forgo group, while being male, unmarried, currently not working, or not residing in northern Taiwan were associated with a lower likelihood.

conclusionsMost respondents expressed a consistent preference to forgo LSTs in the hypothetical clinical scenarios. This suggests that the advance decision, implemented in 2019, may align with public needs. However, given the low completion rate and prevalent preference patterns, policymakers should increase efforts to ensure that those in need have access to appropriate resources and consider implementing a tiered signing process.

Indexed as

Advance DirectivesDecision MakingLife Support CarePatient PreferenceAdultAgedAged, 80 and overCross-Sectional StudiesDementiaFemaleHumansMaleMiddle AgedMotor Neuron DiseaseQuality of LifeSurveys and QuestionnairesAdvance care planningAdvance decisionAdvance directiveLatent class analysisLife support carePalliative care

Identifiers

PMID40616083
PMCPMC12231297

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.