title: Knowledge of the law about withholding or withdrawing life-sustaining treatment by intensivists and other specialists.
abstract: OBJECTIVE
  Decisions about withholding or withdrawing life-sustaining treatment (WWLST) from adults who lack capacity are an integral part of intensive care (IC) practice. We compare the knowledge, attitudes and practice of intensivists in relation to the law about WWLST with six other specialties most often involved in end-of-life care.
  
  
  METHODS
  We used a cross-sectional postal survey of medical specialists in the three most populous Australian states, and analysed responses from 867 medical specialists from the seven specialties most likely to be involved in WWLST decisions in the acute-care setting (emergency, geriatric, palliative, renal and respiratory medicine, medical oncology and IC).
  
  
  METHODS
  Attitudes to, and knowledge and practice of, the law relating to end-of-life care.
  
  
  RESULTS
  Of 2702 surveys sent to eligible practitioners, 867 completed questionnaires were returned. There was an overall response rate of 32% and an IC response rate also of 32% (125/388). Intensivists performed better than average in legal knowledge but important knowledge gaps remain. Intensivists had a more negative attitude to the role of law in this area than other specialty groups but reported being seen as a leading source of information about legal issues by other medical specialists and nurses. Intensivists also reported being the specialists most frequently making decisions about end-of-life treatment.
  
  
  CONCLUSIONS
  Improved legal knowledge and open engagement with the law can help manage the risk of harm to patients and protect intensivists from liability. IC guidelines and continuing professional development are important strategies to address these issues.
authors.affiliation: Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology, Brisbane, QLD, Australia. bp.white@qut.edu.au.
authors.forename: Ben
authors.initials: B
authors.lastname: White
authors.affiliation: Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Lindy
authors.initials: L
authors.lastname: Willmott
authors.affiliation: Southern Cross University, Lismore, QLD, Australia.
authors.forename: Colleen
authors.initials: C
authors.lastname: Cartwright
authors.affiliation: School of Medicine, University of Queensland, Brisbane, QLD, Australia.
authors.forename: Malcolm H
authors.initials: MH
authors.lastname: Parker
authors.affiliation: School of Public Health, University of Queensland, Brisbane, QLD, Australia.
authors.forename: Gail
authors.initials: G
authors.lastname: Williams
mesh_terms: D001291:Attitude of Health Personnel; D001315:Australia; D002983:Clinical Competence / Q000331:legislation & jurisprudence*; D003422:Critical Care / Q000331:legislation & jurisprudence*; D003430:Cross-Sectional Studies; D006801:Humans; D013038:Specialization / Q000331:legislation & jurisprudence; D013727:Terminal Care / Q000331:legislation & jurisprudence*; D028761:Withholding Treatment / Q000331:legislation & jurisprudence*