Interview assessment of critically Ill patients regarding resuscitation decisions. A case study in ethics research.
To examine how patients perceive and decide their resuscitation status, we monitored 113 admissions to a coronary care unit. We review the research process, including Institutional Review Board concerns, sampling bias and permission by physicians, informed consent, and the patient interview. In-depth psychiatric interviews on 16 patients demonstrated marked misperceptions about resuscitation procedures. Although standardized psychologic measures indicated distress in some of these critically ill patients, the interview itself induced no detected untoward physiologic or emotional reactions. This pilot study demonstrates the feasibility of assessing patients regarding resuscitation status and also identifies relevant methodologic problems to guide future research of resuscitation decision-making.
Amchin
J
J
Consultation-Liaison Psychiatry Program, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213.
Perry
S
S
Manevitz
A
A
Cella
D
D
Miller
D
D
D035841:Behavioral Research; D003325:Coronary Care Units; D003422:Critical Care / Q000331:legislation & jurisprudence*; D028741:Ethics Committees, Clinical; D028744:Ethics Committees, Research; D004992:Ethics, Medical; D005065:Euthanasia / Q000523:psychology*; D005066:Euthanasia, Passive / Q000523:psychology*; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D007362:Intensive Care Units; D007406:Interview, Psychological / Q000379:methods*; D011581:Psychological Tests; D012017:Referral and Consultation / Q000331:legislation & jurisprudence*; D012151:Resuscitation / Q000523:psychology*; D012803:Sick Role