[Taking decisions at the end of life. A survey of the attitude of critically ill patients against death].
OBJECTIVE
An attitude of refusal regarding death still persists in our society and the majority of patients do not usually take decisions related to the end of life.


METHODS
From June 1st to December 31st, 2000, 88 first-degree relatives were interviewed concerning patient's preparation before his/her death. Patients considered to be candidates to take decisions about end of life were those with poor quality of life and previously admitted to the intensive care unit (ICU). Relatives were interviewed regarding organ donation, vital willingness, legal representative, civil willingness and patient's knowledge of disease and wish to limit therapeutic efforts in case of extreme severity. Previous quality of life was measured according to the Karnofsky scale.


RESULTS
20% patients had donated organs, none had vital willingness and 44% had civil willingness. When patients were divided into groups of those with and without legal willingness, vital representative, and willgness to donate organs and to limit therapeutic effort, there were no statistically significant differences except for patients with vital representatives who were significantly younger.


CONCLUSIONS
Society needs to advance progressively towards the acceptance and preparation of death, so that decisions taken at the end of life, particularly in the ICUs, may represent, as accurately as possible, a patient's scale of values.
Solsona
José F
JF
Servicio de Medicina Intensiva, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, España. 13713@imas.imim.es
Sucarrats
Alexandra
A
Maull
Elena
E
Barbat
Cristina
C
García
Silvia
S
Villares
Sandra
S
D032722:Advance Care Planning / Q000706:statistics & numerical data; D000368:Aged; D001293:Attitude to Death; D016638:Critical Illness / Q000523:psychology*; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013030:Spain