Knowledge of the law about withholding or withdrawing life-sustaining treatment by intensivists and other specialists

White, Benjamin P., Willmott, Lindy, Cartwright, Colleen, Parker, Malcolm, & Williams, Gail (2016) Knowledge of the law about withholding or withdrawing life-sustaining treatment by intensivists and other specialists. Critical Care and Resuscitation, 18(2), pp. 109-115.

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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.

DESIGN, SETTING AND PARTICIPANTS: 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).

MAIN OUTCOME MEASURES: 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.

Impact and interest:

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6 citations in Web of Science®
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ID Code: 97963
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: Health law, Medical law, Adult guardianship law, Withholding and withdrawing life-sustaining treatment, Intensive care, Knowledge of law, Compliance with law, Survey of doctors, End of life decision-making
ISSN: 1441-2772
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Intensive Care (110310)
Australian and New Zealand Standard Research Classification > LAW AND LEGAL STUDIES (180000) > LAW (180100) > Law and Society (180119)
Australian and New Zealand Standard Research Classification > PHILOSOPHY AND RELIGIOUS STUDIES (220000) > APPLIED ETHICS (220100) > Medical Ethics (220106)
Divisions: Current > QUT Faculties and Divisions > Faculty of Law
Current > Research Centres > Australian Centre for Health Law Research
Current > Schools > School of Law
Copyright Owner: Copyright 2016 The Australasian Medical Publishing Company
Deposited On: 08 Aug 2016 00:56
Last Modified: 01 Dec 2016 01:02

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