title: Care of terminally-ill patients: an opinion survey among critical care healthcare providers in the Middle East.
abstract: BACKGROUND
  Modern medicine has allowed physicians to support the dying terminally-ill patient with artificial means. However, a common dilemma faced by physicians in general, and intensivist in particular is when to limit or withdraw aggressive intervention.
  
  
  OBJECTIVE
  To study the effect of training background and seniority on Do-not to resuscitate (DNR) decisions in the Middle East.
  
  
  METHODS
  Anonymous questionnaire sent to members of the Pan Arab Society of Critical Care.
  
  
  RESULTS
  The response rate was 46.2%. Most of the responders were Muslim (86%) and consultants (70.9%). Majority of the responders were trained in western countries. Religion played a major role in 59.3% for making the DNR decision. DNR was considered equivalent to comfort care by 39.5%. In a futile case scenario, Do Not Escalate Therapy was preferred (54.7%). The likelihood of a patient, once labeled DNR, being clinically neglected was a concern among 46.5%. Admission of DNR patients to the ICU was acceptable for 47.7%. Almost one-half of the responders (46.5%) wanted physicians to have the ultimate authority in the DNR decision. Training background was a significant factor affecting the interpretation of the term no code DNR (P< 0.008).
  
  
  CONCLUSIONS
  Training background and level of seniority in critical care provider does not impact opinion on most of end of life issues related to care of terminally-ill patients. However, DNR is considered equivalent to comfort care among majority of Middle Eastern trained physicians.
authors.affiliation: Tawam Hospital in affiliation with Johns Hopkins, Al-Ain, United Arab Emirates.
authors.forename: M
authors.initials: M
authors.lastname: ur Rahman
authors.affiliation: Tawam Hospital in affiliation with Johns Hopkins, Al-Ain, United Arab Emirates.
authors.forename: S
authors.initials: S
authors.lastname: Abuhasna
authors.affiliation: Trauma Group, Faculty of Medicine & Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
authors.forename: F M
authors.initials: FM
authors.lastname: Abu-Zidan
mesh_terms: D001291:Attitude of Health Personnel; D003422:Critical Care; D003657:Decision Making; D005260:Female; D019538:Health Care Surveys; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008877:Middle East; D016414:Resuscitation Orders; D011795:Surveys and Questionnaires; D019452:Terminally Ill
keywords: Do-not resuscitate; Islam; care of terminally-ill; opinion; training