The Durban World Congress Ethics Round Table Conference Report: II. Withholding or withdrawing of treatment in elderly patients admitted to the intensive care unit

Guidet, Bertrand, Hodgson, Eric, Feldman, Charles, Paruk, Fathima, Lipman, Jeffrey, Koh, Younsuck, Vincent, Jean Louis, Azoulay, Elie and Sprung, Charles L. (2014) The Durban World Congress Ethics Round Table Conference Report: II. Withholding or withdrawing of treatment in elderly patients admitted to the intensive care unit. Journal of Critical Care, 29 6: 896-901. doi:10.1016/j.jcrc.2014.08.004

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Author Guidet, Bertrand
Hodgson, Eric
Feldman, Charles
Paruk, Fathima
Lipman, Jeffrey
Koh, Younsuck
Vincent, Jean Louis
Azoulay, Elie
Sprung, Charles L.
Title The Durban World Congress Ethics Round Table Conference Report: II. Withholding or withdrawing of treatment in elderly patients admitted to the intensive care unit
Journal name Journal of Critical Care   Check publisher's open access policy
ISSN 0883-9441
1557-8615
Publication date 2014-12-01
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.jcrc.2014.08.004
Volume 29
Issue 6
Start page 896
End page 901
Total pages 6
Place of publication Maryland Heights, MO United States
Publisher W.B. Saunders
Language eng
Formatted abstract
Introduction
Life-sustaining treatment (LST) limitation for elderly patients is highly controversial. In that context, it is useful to evaluate the attitudes to LST in the elderly among experienced intensive care unit (ICU) physicians with different backgrounds and cultures.

Methods
A panel of 22 international ICU physicians from 13 countries responded to a questionnaire related to withholding (WH) and withdrawing (WD) LST in elderly patients using a semi-Likert scale.

Results
Most experts disagree or strongly disagree (77%) that age should be used as the sole criterion for WH or WD LST, and almost all disagree (91%) that there should be a specific age for such decision making. However, the vast majority (91%) acknowledge that age should be an important consideration in conjunction with other factors. Disagreement for consideration of prioritizing the young over the old in normal ICU operations was reported in 68%, whereas in an emergency triage situation, disagreement dropped to 18%.

Conclusions
There is a consensus among ICU physicians that age cannot be the sole criterion on which health care decisions should be made. In that perspective, it is important to provide data showing that outcome differences between elderly and nonelderly patients are partly related to decisions to forgo LSTs.
Keyword Elderly
Ethics
Intensive care
Life sustaining treatments
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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