New York, June 1 :
Unlike what they actually practice – pursuing aggressive, life-prolonging treatment for terminally-ill patients – most physicians would like to forego it for themselves, a new study reveals.
“Why do we physicians choose to pursue such aggressive treatment for our patients when we would not choose it for ourselves?” asked V.J. Periyakoil, lead author of the study.
The reasons likely are multifaceted and complex.
An overwhelming percentage of the 2,013 doctors surveyed – 88.3 percent – said they would choose “no-code” or do-not-resuscitate orders for themselves.
In the study, Periyakoil and her colleagues set out to determine how physicians’ attitudes have changed toward advance directives since passage of the US Self-Determination Act in 1990 – a law designed to give patients more control over determining end-of-life-care decisions.
“More than 80 percent of patients say they wish to avoid hospitalisation and high-intensity care at the end of life, but their wishes are often overridden,” the authors noted.
At the core of the problem is a biomedical system that rewards doctors for taking action, not for talking with their patients.
“Our current default is ‘doing,’ but in any serious illness there comes a tipping point where the high-intensity treatment becomes more of a burden than the disease itself,” emphasised Periyakoil who trains physicians in palliative medicine.
The study appeared in the journal PLOS ONE.