Withdrawal of life support--who should decide? Differences in attitudes among the general public, nurses and physicians.
OBJECTIVE
To examine the attitudes of the general public regarding who should decide about the withdrawal of life support and to compare these attitudes with those of intensive care personnel.


METHODS
Nationwide postal questionnaire survey.


METHODS
Sweden.


METHODS
One thousand one hundred ninety-six randomly selected persons from the Swedish population register, 339 nurses and 121 physicians from 29 randomly selected intensive care units (ICUs).


RESULTS
Respondents' answers to questions related to two clinical scenarios: one with a conscious and competent patient and one with an unconscious patient. The response rates were 64 % for the general public, 86 % for the nurses and 88 % for the physicians. Concerning the competent patient, 48 % of the public, 31 % of the nurses and 8 % of the physicians were of the opinion that a decision about continued ventilator treatment should be made by the patient alone or together with the family, but without the physician. The vast majority of physicians (87 %) wanted to make the decision themselves, either alone or together with the patient or family. Concerning the incompetent patient, 73 % of the general public and 70 % of the nurses advocated a joint decision made by the family and the physician together. The majority of the physicians (61 %) regarded themselves as the sole decision-maker, a view supported by only 5 % of the public and 20 % of the nurses.


CONCLUSIONS
While existing Swedish guidelines recommend that the physician should be the sole decision-maker, the general public favour more patient and family influence on the decision to withdraw life support as compared with intensive care physicians.
Sjökvist
P
P
Department of Anesthesia and Intensive Care, Orebro Medical Centre Hospital, SE-701 85 Orebro, Sweden.
Nilstun
T
T
Svantesson
M
M
Berggren
L
L
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D016009:Chi-Square Distribution; D003422:Critical Care; D003657:Decision Making; D005066:Euthanasia, Passive; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology* / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D011639:Public Opinion; D011897:Random Allocation; D011795:Surveys and Questionnaires; D013548:Sweden