When enough is enough; Terminating life-sustaining treatment at the patient's request: A survey of attitudes among Swedish physicians and the general public

Journal of Medical Ethics

Volumn 36, Issue 5, 2010, Pages 284-289

  Lindblad, Anna ^a   Juth, Niklas ^a   Fürst, Carl Johan ^b   Lynöe, Niels ^a  

^a KAROLINSKA INSTITUTE   (Sweden)

^b Stockholms Sjukhem Foundation   (Sweden)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGE; AGED; ARTICLE; ATTITUDE TO DEATH; DECISION MAKING; ETHICS; FEMALE; HEALTH PERSONNEL ATTITUDE; HUMAN; MALE; MIDDLE AGED; PASSIVE EUTHANASIA; PUBLIC OPINION; QUESTIONNAIRE; SEX DIFFERENCE; SWEDEN; TREATMENT REFUSAL;

ADULT; AGE FACTORS; AGED; AGED, 80 AND OVER; ATTITUDE OF HEALTH PERSONNEL; ATTITUDE TO DEATH; DECISION MAKING; EUTHANASIA, PASSIVE; FEMALE; HUMANS; MALE; MIDDLE AGED; PUBLIC OPINION; QUESTIONNAIRES; SEX FACTORS; SWEDEN; TREATMENT REFUSAL; YOUNG ADULT;

EID: 77955888795     PISSN: 03066800     EISSN: 14734257     Source Type: Journal    
DOI: 10.1136/jme.2009.034967     Document Type: Article

References (22)

1. The National Board of Health and Welfare. [Life-sustaining measures at the end of life] (In Swedish). 1992. http://www.socialstyrelsen.se/publikationer1992/1992-70-2 (accessed 7 Dec 2009).
2. The Swedish Society for Anaesthesiology and Intensive Care. [To withhold or withdraw treatment in Swedish intensive care] (In Swedish). 2007. http://www.sfai.se/files/Rikt_Avst%C3%A5-Avbryta_FV_II_SFAI_070219.pdf (accessed 7 Dec 2009).
3. The Swedish Society of Medicine. [When are physicians allowed to withhold treatment?] (In Swedish). 1991. http://www.svls.se/cs-media-old/xyz/000001437.pdf (accessed 7 Dec 2009).
4. Stanley JM. The Appleton Consensus: suggested international guidelines for decisions to forego medical treatment. J Med Ethics 1989;15:129-36.
5. British Medical Association. End-of-life decisions. Views of the BMA. 2009. http://www.bma.org.uk/images/endlifedecisionsaug2009_tcm41-190116.pdf (accessed 7 Dec 2009).
6. Örn P. [Delegation for medical ethics changes the guidelines. Ventilator-dependent competent patient should have physician's help to end life] (In Swedish). Läkartidningen 2007;104:1120-1.
7. Lynöe N, Juth N. [ABZ of Medical Ethics]. (In Swedish). Stockholm: Liber AB, 2009:226-7.
8. Richter J, Eisemann MR, Zgonnikova E. Doctors' attitudes and end-of-life decisions in the elderly: a comparative study between Sweden, Germany and Russia. Arch Gerontol Geriatr 2002;34:107-15.
9. Rydvall A, Lynoe N. Withholding and withdrawing life-sustaining treatment: a comparative study of the ethical reasoning of physicians and the general public. Crit Care 2008;12:R13. http://ccforum.com/content/12/1/R13 (accessed 7 Dec 2009).
10. Sjokvist P, Berggren L, Svantesson M, et al. Should the ventilator be withdrawn? Attitudes of the general public, nurses and physicians. Eur J Anaesthesiol 1999;16:526-33.
11. Sjokvist P, Berggren L, Cook DJ. Attitudes of Swedish physicians and nurses towards the use of life-sustaining treatment. Acta Anaesthesiol Scand 1999;43:167-72.
12. The Swedish Medical Association. [Facts about physicians 2007] (In Swedish). http://www.slf.se/pages/11829/L%C3%A4karfakta_2007.webb.pdf (accessed 7 Dec 2009).
13. Statistics Sweden. Population 1 November by county, age and sex. Year 2002-2009. Last updated 10 December 2009. http://www.ssd.scb.se/databaser/makro/ Visavar.asp?yp=tansss&xu=C9233001&huvudtabell=FolkmangdNov&deltabell=L1&deltabellnamn=Population+1+November+by+county%2C+age+and+sex. +Year&omradekod=BE&omradetext=Population&preskat=O&innehall= FolkmangdNov&starttid=2002&stopptid=2009&Prodid=BE0101&fromSok= &Fromwhere=s&lang=2&langdb=2 (accessed 17 Mar 2010).
14. Bostwick JM, Cohen LM. Differentiating suicide from life-ending acts and end-oflife decisions. A model based on chronic kidney disease and dialysis. Psychosomatics 2009;50:1-7.
15. Abram HS, Moore GL, Westervelt FBJ. Suicidal behavior in chronic dialysis patients. Am J Psychiatry 1971;127:1199-204.
16. CohenLM, SteinbergMD,Hails KC, et al. Psychiatric evaluation of death-hastening requests: lessons from dialysis discontinuation. Psychosomatics 2000;41:195-203.
17. Christakis NA, Asch DA. Biases in how physicians choose to withdraw life support. Lancet 1993;342:642-6.
18. Asch DA, Christakis NA. Why do physicians prefer to withdraw some forms of life support over others? Intrinsic attributes of life-sustaining treatments are associated with physicians' preferences. Med Care 1996;34:103-11.
19. Singer PA, Choudhry S, Armstrong J, et al. Public opinion regarding end-of-life decisions: influence of prognosis, practice and process. Soc Sci Med 1995;41:1517-21.
20. Miccinesi G, Fischer S, Paci E, et al. Physicians' attitudes towards end-oflife decisions: a comparison between seven countries. Soc Sci Med 2005;60: 1961-74.
21. Materstvedt LJ, Clark D, Ellershaw J, et al. Euthanasia and physicianassisted suicide: a view from an EAPC Ethics Task Force. Palliat Med 2003;17:97-101.
22. Marcoux I, Mishara BL, Durand C. Confusion between euthanasia and other end-of-life decisions: influences on public opinion poll results. Can J Public Health 2007;98:235-9.