Are physicians' estimations of future events value-impregnated? Cross-sectional study of double intentions when providing treatment that shortens a dying patient's life.
The aim of the present study was to corroborate or undermine a previously presented conjecture that physicians' estimations of others' opinions are influenced by their own opinions. We used questionnaire based cross-sectional design and described a situation where an imminently dying patient was provided with alleviating drugs which also shortened life and, additionally, were intended to do so. We asked what would happen to physicians' own trust if they took the action described, and also what the physician estimated would happen to the general publics' trust in health services. Decrease of trust was used as surrogate for an undesirable action. The results are presented as proportions with a 95 % Confidence Interval (CI). Statistical analysis was based on inter-rater agreement (Weighted Kappa)-test as well as χ (2) test and Odds Ratio with 95 % CI. We found a moderate inter-rater agreement (Kappa = 0.552) between what would happen with the physicians' own trust in healthcare and their estimations of what would happen with the general population's trust. We identified a significant difference between being pro et contra the treatment with double intentions and the estimation of the general population's trust (χ(2) = 72, df = 2 and p < 0.001). Focusing on either decreasing or increasing own trust and being pro or contra the action we identified a strong association [OR 79 (CI 25-253)]. Although the inter-rater agreement in the present study was somewhat weaker compared to a study about the explicit use of the term 'physicians assisted suicide' we found that our hypothesis-physicians' estimations of others' opinions are influenced by their own opinions-was corroborated. This might have implications in research as well as in clinical decision-making. We suggest that Merton's ideal of disinterestedness should be highlighted.
Unit of Anesthesiology and Intensive Care Medicine, Department of Surgical and Perioperative Sciences, Umeå University, 901 87, Umeå, Sweden.
Anders
A
Rydvall
Niklas
N
Juth
Mikael
M
Sandlund
Niels
N
Lynøe
D003430:Cross-Sectional Studies; D005544:Forecasting; D006801:Humans; D033182:Intention; D010166:Palliative Care / Q000523:psychology; D010820:Physicians / Q000523:psychology*; D017236:Suicide, Assisted / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000379:methods / Q000523:psychology*; D013997:Time Factors; D035502:Trust