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Are physicians on the same page about do-not-resuscitate? To examine individual physicians' influence on do-not-resuscitate decision-making: a retrospective and observational study.
BMC Medical Ethics ( IF 2.7 ) Pub Date : 2019-12-04 , DOI: 10.1186/s12910-019-0429-z Yen-Yuan Chen,Melany Su,Shu-Chien Huang,Tzong-Shinn Chu,Ming-Tsan Lin,Yu-Chun Chiu,Kuan-Han Lin
BMC Medical Ethics ( IF 2.7 ) Pub Date : 2019-12-04 , DOI: 10.1186/s12910-019-0429-z Yen-Yuan Chen,Melany Su,Shu-Chien Huang,Tzong-Shinn Chu,Ming-Tsan Lin,Yu-Chun Chiu,Kuan-Han Lin
BACKGROUND
Individual physicians and physician-associated factors may influence patients'/surrogates' autonomous decision-making, thus influencing the practice of do-not-resuscitate (DNR) orders. The objective of this study was to examine the influence of individual attending physicians on signing a DNR order.
METHODS
This study was conducted in closed model, surgical intensive care units in a university-affiliated teaching hospital located in Northern Taiwan. The medical records of patients, admitted to the surgical intensive care units for the first time between June 1, 2011 and December 31, 2013 were reviewed and data collected. We used Kaplan-Meier survival curves with log-rank test and multivariate Cox proportional hazards models to compare the time from surgical intensive care unit admission to do-not-resuscitate orders written for patients for each individual physician. The outcome variable was the time from surgical ICU admission to signing a DNR order.
RESULTS
We found that each individual attending physician's likelihood of signing do-not-resuscitate orders for their patients was significantly different from each other. Some attending physicians were more likely to write do-not-resuscitate orders for their patients, and other attending physicians were less likely to do so.
CONCLUSION
Our study reported that individual attending physicians had influence on patients'/surrogates' do-not-resuscitate decision-making. Future studies may be focused on examining the reasons associated with the difference of each individual physician in the likelihood of signing a do-not-resuscitate order.
更新日期：2020-04-22
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