A study on the knowledge and attitudes regarding the ethical principles of "End of life decisions" among medical professionals at the teaching hospital Perdeniya
Date
2013-07-04
Authors
Pinto, M. V. G.
Pethiyagoda, K.
Nishantha, P. G.
Varun, R.
Jayesinghearachchi, T. M. K.
Herath, H. M. T. A.
Wanasinghe, W. M. M. P. B.
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Peradeniya
Abstract
Clinical practice of critical care medicine necessitates many end-of-life decisions, like withdrawal or withholding of life sustaining therapy, Advanced Directive and Do-Not- Resuscitate (DNR) orders, which raise many ethical dilemmas. DNR order is a legal document to respect patient’s wishes to forego Cardio-pulmonary resuscitation, whilst Advanced Directives indicates end-of-life decisions of the patients. Once medical futility is evident, withholding life-sustaining measures which postponed death is termed “Withdrawal or Withholding of life-sustaining therapy”. Sri Lankan legislation does not allow DNR orders ethically or legally and there are no studies conducted related to these ethical principles.
This study was conducted to evaluate the knowledge about these ethical dilemmas, and the attitudes towards implementing these in Sri Lanka, in a group of medical professionals.
This was a cross sectional study carried out among 55 randomly selected doctors, working at the Teaching Hospital, Peradeniya, using a pre-tested self administered questionnaire. The knowledge and the attitudes were assessed with regards to advanced directives, DNR order and withdrawal of life sustaining therapy by scenario based and close ended questions. Data were analyzed using SPSS 16.0 package. Results were expressed as percentages depending on the variable in the final analysis.
Out of the subjects, 80% had heard the term “DNR” orders, while 26% knew the correct meaning and 68% thought it to be ethical to practice it in Sri Lanka. Opinions as to whether the patient, doctor or the family should have the right to decide on end-of-life decision was 61%, 51% and 11% respectively. 17% had heard about Advanced Directives but only 7% knew the correct meaning. 64% had heard about “withdrawal/ withholding” of life sustaining therapy and 70% opined that it should be implemented in Sri Lanka.
Knowledge about the DNR, advanced directives and withdrawal of life support among this group of medical professionals, was shown to be inadequate. However, the majority of the medical doctors have positive attitudes towards implementation of “end of life decisions” in Sri Lanka.
Description
Keywords
Health and Hygiene , End-of-life decisions , Ethical principals , Medical professionals
Citation
Peradeniya University Research Sessions PURSE - 2012, Book of Abstracts, University of Peradeniya, Sri Lanka, Vol. 17, July. 4. 2012 pp. 138