PERCEPTIONS OF HEALTH PROFESSIONALS, PATIENTS, AND FAMILIES ON DECISION TO DISCONTINUE LIFE-SUSTAINING TREATMENT

Abstract

Abstract Withholding and withdrawing treatment is debated among health professionals who care for individuals at the end of life. This study aimed to compare the perception of life-sustaining treatment decisions by health professionals, patients, and families by providing data to guide medical professionals to support patients in making self-directed decisions about when to limit or continue their life-sustaining treatment. A descriptive survey was conducted with health professionals (220 from general tertiary hospitals) and 110 patients and their families. The majority of participants (85-95%) agreed with the suspension of meaningless life-sustaining treatment. In a clinical situation, the decision was made mainly by the family (84%), followed by the patient (10%) or the primary doctor (6%). However, the patients and their families reported that patients should make decisions (74%). The appropriate timing to discuss the suspension of the life-sustaining treatment was when the patients were still conscious but expecting severe deterioration” consistently reported by participants (45-58%). The most important factor during their decision-making would be “possibility of the patient’s recovery” by health professionals (43-55%), but “pain of the patients (58%)” was reported by the patients and their families. In conclusion, there is still a significant discrepancy in the perception of life-sustaining treatment decisions among health professionals, patients, and their families. The ambiguity of the timing for the decision to terminate life-sustaining treatment and the discrepancy between patients and their families’ opinions remain obstacles to implementing the Act to respect the patient’s right to self-determination and achieve the goal of a dignified end-of-life.