Abstract
Amaç: Bu çalışmada amaç hekimlerin terminal dönemde olan bir hastalıkları olması halinde kendilerine
uygulanmasını istedikleri ya da istemedikleri tedavileri saptamak ve yaptıkları bu tercihlerinin yaş ve
hekimlik yılı ya da branş gibi parametrelerden etkilenip etkilenmediğini gözlemlemektir.
Materyal ve Metot: Hekimlere açık ve kapalı uçlu 22 sorudan oluşan anket uygulandı. Sorularda
hayatın son döneminde olan hastalarla hiç görüşme yapıp yapmadıkları ve bu konuda eğitim alıp
almadıkları, hayatın son dönemimde olsalar hastanede mi, evde mi, yoğun bakımda mı yoksa palyatif
bakım merkezinde mi ölmek istedikleri ve invaziv işlemlerle ilgili fikirleri soruldu. Ayrıca hayatın
sonuna dair istekleri konusunda yakınlarına bilgi verip vermedikleri soruldu.
Bulgular: Çalışmaya 443 hekim katıldı. Hekimlerin %77,42’i son dönemde olan bir hastalıkları olması
durumunda evde ölmeyi tercih edeceğini belirtti. Kararsız olan ya da hastanede ölmek istediğini
belirtenlerin %44’ü de yoğun bakımda ölmek istemediğini belirtmiştir. Bir hastalığın terminal
döneminde olsalar çalışmamıza katılan hekimlerin %72,46’sı kendisine göğüs kompresyonu yapılmasını,
%75,62’i entübe edilip ventilatöre bağlanmayı istememiştir. %57,56’si kendisine santral kateter
takılmasını istemeyeceğini, %49,88’si diyalize girmek istemeyeceğini, %61,17’i ise PEG takılmasını
istemediğini belirtmiştir. Hayatın sonuna dair istekleri konusunda yakınları ile konuşan doktorların
oranı sadece %17,15’dir.
Sonuç: Bütün bu cevaplar dikkate alındığında hekimlerin son dönemde olan bir hastalıkları olsa
çoğunlukla evde ölmek istediklerini ve invaziv işlemlere maruz kalmak istemedikleri görülmektedir.
Ancak hekimlerin çoğunluğunun bu konudaki görüşlerini yakınları ile paylaşmadıkları da gözlenmiştir.
References
- References 1. Silverman HJ, Vinicky JK, Gasner MR. Advance directives: Implication forcritical care. Crit Care Med 1992;20(7):1027-31.
- 2. Detering KM, Hancock AD, Reade MC, et al. Theimpact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ 2010;340:c1345.
- 3. Lurkin W, Neate SL, White B. End of life decision making and palliative care. In: Cameron P, Jelinek B, Kelly AM, Brown A, Little M. Textbook of Adult Emergency Medicine, 4th ed. Toronto: Elsevier; 2015;727-9.
- 4. Tardy B, Venet C, Zeni F, et al. Death of terminally ill patients on a stretcher in the emergency department: a French speciality? Intensive Care Med 2002;28 (11):1625-8.
- 5. Cartwright CM, Parker M. Advance care planning and end of life decision-making. AustFamPhys.2004;33(10):815-9.
- 6. Willmott L, White B, Parker M, et al. The legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment: Part 2 (Queensland). J Law Med 2011;18(3):523-44.
- 7. Willmott L, White B, Parker M, et al. The legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment: Part 3 (Victoria). J Law Med 2011;18:773-97.
- 8. Bishop JP, Brothers KB, Perry JE, et al. Reviving the conversation around CPR/DNR. Am J Bioeth 2010;10(1):61-7.
- 9. Scripko PD, Greer DM. Practical considerations for reviving the CPR/DNR conversation. Am J Bioeth 2010;10(1):74-5.
- 10. Kaldjian LC, Erekson ZD, Haberle TH, et al. Code status discussions and goals of care among hospitalised adults. J Med Ethics 2009;35(6):338-42.
- 11. Fritz Z, Fuld J. Ethical issues surrounding do not attempt resuscitation orders: decisions, discussions and deleterious effects. J Med Ethics 2010;36(10):593-7.
- 12. Tıbbi Vasiyet çalıştay raporu [İnternet] http://mevlutulgen.com/images/Tıbbi_Vasiyet_Çalıştay-min_compressed.pdf [accessed on 22.11.2018].
- 13. Le Conte P, Riochet D, Batard E, et al. Death in emergency departments: a multicenter cross-sectional survey with analysis of withholding and withdrawing life support. Intensive Care Med 2010; 36(5):765-72.
- 14. Cartwright CM, White BP, Willmott L, et al. Palliative care and other phisicianss’ knowledge, attitudes and practice relating to the law on with holding/ withdrawing life-sustaining treatment: Survey results. Palliat Med 2016;30(2):171-9.
Abstract
Objectives: The purpose of this
study is to determine the treatments that physicians prefer to receive, if they
had a terminal stage illness and to observe whether these preferences are
influenced by parameters such as age, work years in the profession or
specialty.
Materials and Methods: A survey
consisting of 22 questions was delivered to physicians. The physicians were
asked if they were prefer to die in hospital, home, intensive care unit or
palliative care center if they were terminally ill; and they would want invasive
procedures performed. They were also asked whether they informed their
relatives about those preferences.
Results: A total of 443 physicians
participated in the study, 77.42% of them stated that they would prefer to die
at home if they had a terminal illness. Regarding invasive procedures; 72.46%
of the physicians did not want chest compressions, 75.62 % did not want to be
connected to the ventilator, 57.56% did not want a central catheter, 49.88% did
not want hemodialysis, and 61.17% did not want a feeding tube placement. Only
17.15% of physicians stated that they had talked with their relatives about end
of life decisions.
Conclusion: In this study we found
that most physicians want to die at home and do not wish to be treated with
invasive interventions in case they had a life limiting illness. However, we also
observed that the majority of the physicians do not share these opinions with
their close ones.
References
- References 1. Silverman HJ, Vinicky JK, Gasner MR. Advance directives: Implication forcritical care. Crit Care Med 1992;20(7):1027-31.
- 2. Detering KM, Hancock AD, Reade MC, et al. Theimpact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ 2010;340:c1345.
- 3. Lurkin W, Neate SL, White B. End of life decision making and palliative care. In: Cameron P, Jelinek B, Kelly AM, Brown A, Little M. Textbook of Adult Emergency Medicine, 4th ed. Toronto: Elsevier; 2015;727-9.
- 4. Tardy B, Venet C, Zeni F, et al. Death of terminally ill patients on a stretcher in the emergency department: a French speciality? Intensive Care Med 2002;28 (11):1625-8.
- 5. Cartwright CM, Parker M. Advance care planning and end of life decision-making. AustFamPhys.2004;33(10):815-9.
- 6. Willmott L, White B, Parker M, et al. The legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment: Part 2 (Queensland). J Law Med 2011;18(3):523-44.
- 7. Willmott L, White B, Parker M, et al. The legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment: Part 3 (Victoria). J Law Med 2011;18:773-97.
- 8. Bishop JP, Brothers KB, Perry JE, et al. Reviving the conversation around CPR/DNR. Am J Bioeth 2010;10(1):61-7.
- 9. Scripko PD, Greer DM. Practical considerations for reviving the CPR/DNR conversation. Am J Bioeth 2010;10(1):74-5.
- 10. Kaldjian LC, Erekson ZD, Haberle TH, et al. Code status discussions and goals of care among hospitalised adults. J Med Ethics 2009;35(6):338-42.
- 11. Fritz Z, Fuld J. Ethical issues surrounding do not attempt resuscitation orders: decisions, discussions and deleterious effects. J Med Ethics 2010;36(10):593-7.
- 12. Tıbbi Vasiyet çalıştay raporu [İnternet] http://mevlutulgen.com/images/Tıbbi_Vasiyet_Çalıştay-min_compressed.pdf [accessed on 22.11.2018].
- 13. Le Conte P, Riochet D, Batard E, et al. Death in emergency departments: a multicenter cross-sectional survey with analysis of withholding and withdrawing life support. Intensive Care Med 2010; 36(5):765-72.
- 14. Cartwright CM, White BP, Willmott L, et al. Palliative care and other phisicianss’ knowledge, attitudes and practice relating to the law on with holding/ withdrawing life-sustaining treatment: Survey results. Palliat Med 2016;30(2):171-9.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | December 27, 2018 |
| Published in Issue | Year 2018 Volume: 18 Issue: 4 |
