title: Discrepancies of the Values on the Withholding Futile Interventions between Physician and Family Members of Terminal Cancer Patients.
abstract: OBJECTIVE
  To analyze the controversies surrounding therapeutic decision-making and the withholding of life- sustaining treatments, values held concerning therapeutic interventions of terminal cancer patients are compared between physicians and family members.
  
  
  METHODS
  42 advanced or terminal stage cancer patients were enrolled for the study. The questionnaires were administered to the duty doctor and the family of the patients. Questions included whether to use new agents with a 15% partial efficacy and whether to use opioid analgesics, intravenous nutrition, a feeding tube, antibiotics, and hemodialysis. Additionally, we asked about the administration of CPR, ventilator application, and euthanasia. If the family permitted, the same questionnaires were given to the patients.
  
  
  RESULTS
  Of the 42 cases, 5 families refused to answer the questionnaire. Of the available 37 families, only 5 families permitted access to the patients. Of the 5 patients, 2 patients refused the questionnaire. Only 67.6% and 8.1% of families and the patients clearly understood the stage of cancer. The use of a new agent was accepted by 45.2% of the physicians and 45.9% of the families. The rankings of the acceptance of treatment in the physicians and in the families were similar. The concordance rate between the physicians and the families was lowest on ventilator application and CPR. 31% of the physicians and 43.2% of the families agreed on the issue of euthanasia.
  
  
  CONCLUSIONS
  Values held on issues like therapeutic decision-making and the withholding of life-sustaining treatments in terminal cancer patients are discordant between physicians and family members. In order to resolve controversies on the role of physicians in end-of-life decisions, the values of physicians as well as patients and their family members should be considered in the final decision-making process.
authors.forename: Do Y
authors.initials: DY
authors.lastname: Oh
authors.forename: M R
authors.initials: MR
authors.lastname: Kim
authors.forename: I S
authors.initials: IS
authors.lastname: Choi
authors.forename: Y H
authors.initials: YH
authors.lastname: Joh
authors.forename: B S
authors.initials: BS
authors.lastname: Kim
authors.forename: Do Y
authors.initials: DY
authors.lastname: Kim
authors.forename: J H
authors.initials: JH
authors.lastname: Kim
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.forename: T Y
authors.initials: TY
authors.lastname: Kim
authors.forename: D S
authors.initials: DS
authors.lastname: Heo
authors.forename: Y J
authors.initials: YJ
authors.lastname: Bang
authors.forename: N K
authors.initials: NK
authors.lastname: Kim
keywords: Euthanasia; Futility; Terminal cancer patient; Withholding treatment