Medical and nonmedical determinants of decision making about potentially life-prolonging interventions.
Patient characteristics may influence medical decision making in various ways. The contribution of several patient characteristics to medical decision making was studied. Thirty oncologists, 29 nursing home physicians, and 22 cardiologists were interviewed (overall response = 60%). Respondents were asked whether they would apply a specified intervention for a number of hypothetical seriously ill patients, who varied with respect to factors that were not relevant to the outcome of treatment. The condition that made patients clearly eligible for treatment was kept constant. In a multivariate regression model, patients with a better physical condition, a more obvious social role, and a lower age were more likely to be treated than were other patients. Medical decision making is not exclusively based on empirical evidence but also related to morally complex issues such as patient age and social status.
van der Heide
Agnes
A
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. a.vanderheide@erasmusmc.nl
Vrakking
Astrid
A
van Delden
Hans
H
Looman
Caspar
C
van der Maas
Paul
P
D000328:Adult; D000367:Age Factors; D001291:Attitude of Health Personnel; D002309:Cardiology; D016638:Critical Illness / Q000628:therapy*; D003657:Decision Making; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007407:Interviews as Topic; D008020:Life Support Care / Q000706:statistics & numerical data*; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009426:Netherlands; D009735:Nursing Homes; D012044:Regression Analysis