Life-sustaining treatments

What do physicians want and do they express their wishes to others?

Joseph J Gallo, Joseph B. Straton, Michael John Klag, Lucy Ann Meoni, Daniel P. Sulmasy, Nae Yuh Wang, Daniel E Ford

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To assess whether older physicians have discussed their preferences for medical care at the end of life with their physicians, whether they have established an advance directive, and what life-sustaining treatment they wish in the event of incapacity to make these decisions for themselves. DESIGN: Mailed survey to a cohort of physicians. SETTING: Physicians who were medical students at the Johns Hopkins University in graduating classes from 1946 to 1964. PARTICIPANTS: Physicians who completed the advance directive questionnaire (mean age 68). MEASUREMENTS: Questionnaires were sent out to known surviving physicians of the Precursors Study, an on-going study that began in 1946, asking physicians about their preferences for life-sustaining treatments. RESULTS: Of 999 physicians who were sent the survey, 765 (77%) responded. Forty-six percent of the physicians felt that their own doctors were unaware of their treatment preferences or were not sure, and of these respondents, 59% had no intention of discussing their wishes with their doctors within the next year. In contrast, 89% thought their families were probably or definitely aware of their preferences. Sixty-four percent reported that they had established an advance directive. Compared with physicians without advance directives, physicians who established an advance directive were more likely to believe that their doctors (odds ratio (OR) = 3.42, 95% confidence interval (CI) = 2.49-4.69) or family members (OR = 9.58, 95% CI = 5.33-17.23) were aware of their preferences for end-of-life care and were more likely to refuse treatments than those without advance directives. CONCLUSION: This survey of physicians calls attention to the gap between preferences for medical care at the end of life and expressing wishes to others through discussion and advance directives, even among physicians.

Original languageEnglish (US)
Pages (from-to)961-969
Number of pages9
JournalJournal of the American Geriatrics Society
Volume51
Issue number7
DOIs
StatePublished - Jul 1 2003

Fingerprint

Advance Directives
Physicians
Terminal Care
Therapeutics
Odds Ratio
Confidence Intervals
Medical Students
Surveys and Questionnaires

Keywords

  • Advance directives
  • Aged
  • Decision making
  • Ethics
  • Physicians

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Life-sustaining treatments : What do physicians want and do they express their wishes to others? / Gallo, Joseph J; Straton, Joseph B.; Klag, Michael John; Meoni, Lucy Ann; Sulmasy, Daniel P.; Wang, Nae Yuh; Ford, Daniel E.

In: Journal of the American Geriatrics Society, Vol. 51, No. 7, 01.07.2003, p. 961-969.

Research output: Contribution to journalArticle

@article{c66c7113a59e47dc8cacc3b41ebac272,
title = "Life-sustaining treatments: What do physicians want and do they express their wishes to others?",
abstract = "OBJECTIVES: To assess whether older physicians have discussed their preferences for medical care at the end of life with their physicians, whether they have established an advance directive, and what life-sustaining treatment they wish in the event of incapacity to make these decisions for themselves. DESIGN: Mailed survey to a cohort of physicians. SETTING: Physicians who were medical students at the Johns Hopkins University in graduating classes from 1946 to 1964. PARTICIPANTS: Physicians who completed the advance directive questionnaire (mean age 68). MEASUREMENTS: Questionnaires were sent out to known surviving physicians of the Precursors Study, an on-going study that began in 1946, asking physicians about their preferences for life-sustaining treatments. RESULTS: Of 999 physicians who were sent the survey, 765 (77{\%}) responded. Forty-six percent of the physicians felt that their own doctors were unaware of their treatment preferences or were not sure, and of these respondents, 59{\%} had no intention of discussing their wishes with their doctors within the next year. In contrast, 89{\%} thought their families were probably or definitely aware of their preferences. Sixty-four percent reported that they had established an advance directive. Compared with physicians without advance directives, physicians who established an advance directive were more likely to believe that their doctors (odds ratio (OR) = 3.42, 95{\%} confidence interval (CI) = 2.49-4.69) or family members (OR = 9.58, 95{\%} CI = 5.33-17.23) were aware of their preferences for end-of-life care and were more likely to refuse treatments than those without advance directives. CONCLUSION: This survey of physicians calls attention to the gap between preferences for medical care at the end of life and expressing wishes to others through discussion and advance directives, even among physicians.",
keywords = "Advance directives, Aged, Decision making, Ethics, Physicians",
author = "Gallo, {Joseph J} and Straton, {Joseph B.} and Klag, {Michael John} and Meoni, {Lucy Ann} and Sulmasy, {Daniel P.} and Wang, {Nae Yuh} and Ford, {Daniel E}",
year = "2003",
month = "7",
day = "1",
doi = "10.1046/j.1365-2389.2003.51309.x",
language = "English (US)",
volume = "51",
pages = "961--969",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Life-sustaining treatments

T2 - What do physicians want and do they express their wishes to others?

AU - Gallo, Joseph J

AU - Straton, Joseph B.

AU - Klag, Michael John

AU - Meoni, Lucy Ann

AU - Sulmasy, Daniel P.

AU - Wang, Nae Yuh

AU - Ford, Daniel E

PY - 2003/7/1

Y1 - 2003/7/1

N2 - OBJECTIVES: To assess whether older physicians have discussed their preferences for medical care at the end of life with their physicians, whether they have established an advance directive, and what life-sustaining treatment they wish in the event of incapacity to make these decisions for themselves. DESIGN: Mailed survey to a cohort of physicians. SETTING: Physicians who were medical students at the Johns Hopkins University in graduating classes from 1946 to 1964. PARTICIPANTS: Physicians who completed the advance directive questionnaire (mean age 68). MEASUREMENTS: Questionnaires were sent out to known surviving physicians of the Precursors Study, an on-going study that began in 1946, asking physicians about their preferences for life-sustaining treatments. RESULTS: Of 999 physicians who were sent the survey, 765 (77%) responded. Forty-six percent of the physicians felt that their own doctors were unaware of their treatment preferences or were not sure, and of these respondents, 59% had no intention of discussing their wishes with their doctors within the next year. In contrast, 89% thought their families were probably or definitely aware of their preferences. Sixty-four percent reported that they had established an advance directive. Compared with physicians without advance directives, physicians who established an advance directive were more likely to believe that their doctors (odds ratio (OR) = 3.42, 95% confidence interval (CI) = 2.49-4.69) or family members (OR = 9.58, 95% CI = 5.33-17.23) were aware of their preferences for end-of-life care and were more likely to refuse treatments than those without advance directives. CONCLUSION: This survey of physicians calls attention to the gap between preferences for medical care at the end of life and expressing wishes to others through discussion and advance directives, even among physicians.

AB - OBJECTIVES: To assess whether older physicians have discussed their preferences for medical care at the end of life with their physicians, whether they have established an advance directive, and what life-sustaining treatment they wish in the event of incapacity to make these decisions for themselves. DESIGN: Mailed survey to a cohort of physicians. SETTING: Physicians who were medical students at the Johns Hopkins University in graduating classes from 1946 to 1964. PARTICIPANTS: Physicians who completed the advance directive questionnaire (mean age 68). MEASUREMENTS: Questionnaires were sent out to known surviving physicians of the Precursors Study, an on-going study that began in 1946, asking physicians about their preferences for life-sustaining treatments. RESULTS: Of 999 physicians who were sent the survey, 765 (77%) responded. Forty-six percent of the physicians felt that their own doctors were unaware of their treatment preferences or were not sure, and of these respondents, 59% had no intention of discussing their wishes with their doctors within the next year. In contrast, 89% thought their families were probably or definitely aware of their preferences. Sixty-four percent reported that they had established an advance directive. Compared with physicians without advance directives, physicians who established an advance directive were more likely to believe that their doctors (odds ratio (OR) = 3.42, 95% confidence interval (CI) = 2.49-4.69) or family members (OR = 9.58, 95% CI = 5.33-17.23) were aware of their preferences for end-of-life care and were more likely to refuse treatments than those without advance directives. CONCLUSION: This survey of physicians calls attention to the gap between preferences for medical care at the end of life and expressing wishes to others through discussion and advance directives, even among physicians.

KW - Advance directives

KW - Aged

KW - Decision making

KW - Ethics

KW - Physicians

UR - http://www.scopus.com/inward/record.url?scp=0038148410&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038148410&partnerID=8YFLogxK

U2 - 10.1046/j.1365-2389.2003.51309.x

DO - 10.1046/j.1365-2389.2003.51309.x

M3 - Article

VL - 51

SP - 961

EP - 969

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 7

ER -