Most Physicians Would Forgo Aggressive Treatment for Themselves At End of Life
Stanford, CA - Most physicians would choose a do-not-resuscitate or “no code” status for themselves when they are terminally ill, yet they tend to pursue aggressive, life-prolonging treatment for patients facing the same prognosis, according to a study from the Stanford University School of Medicine.
It’s a disconnect that needs to be better understood, said VJ Periyakoil, MD, clinical associate professor of medicine and lead author of the study, which was published May 28 in PLOS ONE.
“Why do we physicians choose to pursue such aggressive treatment for our patients when we wouldn’t choose it for ourselves?” said Periyakoil, director of the Stanford Palliative Care Education and Training Program. “The reasons likely are multifaceted and complex.”
In the study, Periyakoil and her colleagues set out to determine how physicians’ attitudes have changed toward advance directives since passage of the Self-Determination Act in 1990, a law designed to give patients more control over determining end-of-life-care decisions. Advance directives are documents that patients can use to indicate end-of-life care preferences.
The study involved two sets of subjects: One comprised 1,081 physicians who in 2013 completed a web-based advanced directive form and a 14-item advance directive attitude survey at Stanford Hospital & Clinics and the Veterans Affairs Palo Alto Health Care System; the other comprised 790 physicians from Arkansas who were asked the same 14 survey questions — but did not complete an advance directive form — in a 1989 study published in the Journal of the American Medical Association. Continue>
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