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Research article
Difficulties doctors experience during life-sustaining treatment discussion after enactment of the Life-Sustaining Treatment Decisions Act: A cross-sectional study
Shin Hye Yoo
Seoul National University Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7473-1082
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
In the Republic of Korea, life-sustaining treatment (LST) for patients at the end of life should be legally discussed by a doctor according to the LST Decisions Act, which was enacted in February 2018. However, little is known about challenges doctors experience during LST discussion. This study aims to investigate the perceived difficulties of doctors during LST discussions after enactment of the new Act.
Methods
A cross-sectional survey was conducted in a tertiary hospital in August 2019 and included 686 doctors (432 attending physicians, 141 clinical fellows, and 295 residents) who care for seriously ill patients. The doctors were given a structured questionnaire, and difficulties during the discussion process were examined.
Results
A total of 132 doctors answered the questionnaire. Most (86.4%) experienced considerable difficulties during LST discussions (mean score, 7.4 ± 1.6/10). The two most common difficulties were communication with patients and family and determining when to discuss LST. Two-thirds of doctors found direct discussions with the patient difficult and said they would initiate LST discussions only with family. LST discussions were actually initiated later than considered appropriate. When medically assessing whether the patient is imminently dying, 56% of doctors experienced disagreements with other doctors, which could affect their decisions.
Conclusion
In the present study, most doctors experienced serious difficulties during LST discussions. To alleviate these difficulties, further institutional support is needed.
Keywords
end-of-life care, difficulty, discussion, decision making, life-sustaining treatment
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This is a preprint. It has not completed peer review.
Research article
Difficulties doctors experience during life-sustaining treatment discussion after enactment of the Life-Sustaining Treatment Decisions Act: A cross-sectional study
Shin Hye Yoo
Seoul National University Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7473-1082
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 15 May, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
In the Republic of Korea, life-sustaining treatment (LST) for patients at the end of life should be legally discussed by a doctor according to the LST Decisions Act, which was enacted in February 2018. However, little is known about challenges doctors experience during LST discussion. This study aims to investigate the perceived difficulties of doctors during LST discussions after enactment of the new Act.
Methods
A cross-sectional survey was conducted in a tertiary hospital in August 2019 and included 686 doctors (432 attending physicians, 141 clinical fellows, and 295 residents) who care for seriously ill patients. The doctors were given a structured questionnaire, and difficulties during the discussion process were examined.
Results
A total of 132 doctors answered the questionnaire. Most (86.4%) experienced considerable difficulties during LST discussions (mean score, 7.4 ± 1.6/10). The two most common difficulties were communication with patients and family and determining when to discuss LST. Two-thirds of doctors found direct discussions with the patient difficult and said they would initiate LST discussions only with family. LST discussions were actually initiated later than considered appropriate. When medically assessing whether the patient is imminently dying, 56% of doctors experienced disagreements with other doctors, which could affect their decisions.
Conclusion
In the present study, most doctors experienced serious difficulties during LST discussions. To alleviate these difficulties, further institutional support is needed.
Figure 1
Figure 2
Figure 3
Figure 4