Palliative care and other physicians' knowledge, attitudes and practice relating to the law on withholding/withdrawing life-sustaining treatment: survey results

Cartwright, Colleen Maria, White, Ben P., Willmott, Lindy, Williams, Gail and Parker, Malcolm Holbrook (2016) Palliative care and other physicians' knowledge, attitudes and practice relating to the law on withholding/withdrawing life-sustaining treatment: survey results. Palliative Medicine, 30 2: 171-179. doi:10.1177/0269216315587996


Author Cartwright, Colleen Maria
White, Ben P.
Willmott, Lindy
Williams, Gail
Parker, Malcolm Holbrook
Title Palliative care and other physicians' knowledge, attitudes and practice relating to the law on withholding/withdrawing life-sustaining treatment: survey results
Journal name Palliative Medicine   Check publisher's open access policy
ISSN 1477-030X
0269-2163
Publication date 2016-02-01
Year available 2015
Sub-type Article (original research)
DOI 10.1177/0269216315587996
Open Access Status Not Open Access
Volume 30
Issue 2
Start page 171
End page 179
Total pages 9
Place of publication London, United Kingdom
Publisher Sage Publications
Language eng
Formatted abstract
Background: To effectively care for people who are terminally ill, including those without decision-making capacity, palliative care physicians must know and understand the legal standing of Advance Care Planning in their jurisdiction of practice. This includes the use of advance directives/living wills and substitute decision-makers who can legally consent to or refuse treatment if there is no valid advance directive.
Aim: This study aimed to investigate the knowledge, attitudes and practices of medical specialists most often involved in end-of-life care in relation to the law on withholding/withdrawing life-sustaining treatment from adults without decision-making capacity.
Design/participants: A pre-piloted survey was posted to specialists in palliative, emergency, geriatric, renal and respiratory medicine; intensive care; and medical oncology in three Australian States. Surveys were analysed using SPSS 20 and SAS 9.3.
Results: The overall response rate was 32% (867/2702) – 52% from palliative care specialists. Palliative care specialists and geriatricians had significantly more positive attitudes towards the law (χ242= 94.352 ; p < 0.001) and higher levels of knowledge about the withholding/withdrawing life-sustaining treatment law (χ27 = 30.033 ; p < 0.001) than did the other specialists, while still having critical gaps in their knowledge.
Conclusion: A high level of knowledge of the law is essential to ensure that patients’ wishes and decisions, expressed through Advance Care Planning, are respected to the maximum extent possible within the law, thereby according with the principles and philosophy of palliative care. It is also essential to protect health professionals from legal action resulting from unauthorised provision or cessation of treatment.
Keyword Advance healthcare planning
Law
Palliative care
Treatment refusal
Withdrawing/withholding life-sustaining treatment
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Published online 22 May 2015

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Public Health Publications
School of Medicine Publications
 
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