Age and life-sustaining treatment. Attitudes of intensive care unit professionals.
BACKGROUND
In Sweden, the official policy is that life-sustaining treatment should not be denied because of chronological age. This policy is also emphasised in a recent official report on priority setting in health care. But is this policy accepted among health care professionals? Do they consider chronological age relevant when decisions to forgo life-sustaining treatment are to be made?


METHODS
Questionnaire survey to physicians, registered nurses and enrolled nurses at the Intensive Care Unit, University Hospital MAS, Malmö, Sweden.


RESULTS
More than 65% of the respondents were of the opinion that chronological age per se influenced decisions about life-sustaining treatment. Fewer, a little more than 40%, answered that it would make a difference to their own judgment about life-sustaining treatment whether the patient is 25 or 75 years old. The respondents were also confronted with 10 different factors characterising patients in need of life-sustaining treatment. According to a majority, advance directive, decision-making capacity, and chronological age should be taken into consideration in these situations.


CONCLUSIONS
The results indicate that chronological age is used as a criterion when decisions to forgo life-sustaining treatment are to be made in the ICU. Many health care professionals also believe that chronological age should be used as a criterion. This is clearly discordant with the official policy in Sweden and other countries, which is that age-based rationing is never justified.
Department of Anaesthesiology, University Hospital MAS, Malmö, Sweden.
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Melltorp
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Nilstun
D016223:Advance Directives; D000367:Age Factors; D001291:Attitude of Health Personnel; D005066:Euthanasia, Passive / Q000523:psychology; D006801:Humans; D007362:Intensive Care Units; D008020:Life Support Care / Q000523:psychology*; D008505:Medical Staff, Hospital / Q000523:psychology*; D011795:Surveys and Questionnaires; D013548:Sweden