Doctors' authoritarianism in end-of-life treatment decisions. A comparison between Russia, Sweden and Germany
Objectives—The study was performed in order to investigate how end-of-life decisions are influenced by cultural and sociopolitical circumstances and to explore the compliance of doctors with patient wishes Participants and measurement—Five hundred and thirty-five physicians were surveyed in Sweden (...
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Online Access: | http://dx.doi.org/10.1136/jme.27.3.186 https://syndication.highwire.org/content/doi/10.1136/jme.27.3.186 |
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crjcrbmj:10.1136/jme.27.3.186 2024-06-23T07:50:59+00:00 Doctors' authoritarianism in end-of-life treatment decisions. A comparison between Russia, Sweden and Germany Richter, Jörg Eisemann, Martin Zgonnikova, Elena 2001 http://dx.doi.org/10.1136/jme.27.3.186 https://syndication.highwire.org/content/doi/10.1136/jme.27.3.186 en eng BMJ Journal of Medical Ethics volume 27, issue 3, page 186-191 ISSN 0306-6800 1473-4257 journal-article 2001 crjcrbmj https://doi.org/10.1136/jme.27.3.186 2024-05-30T08:19:15Z Objectives—The study was performed in order to investigate how end-of-life decisions are influenced by cultural and sociopolitical circumstances and to explore the compliance of doctors with patient wishes Participants and measurement—Five hundred and thirty-five physicians were surveyed in Sweden (Umeå), Germany (Rostock and Neubrandenburg), and in Russia (Arkhangelsk) by a questionnaire. The participants were recruited according to availability and are not representative. The questionnaire is based on the one developed by Molloy and co-workers in Canada which contains three case vignettes about an 82-year-old Alzheimer patient with an acute life-threatening condition; the questionnaire includes different levels of information about his treatment wishes. We have added various questions about attitudes determining doctors' decision making process (legal and ethical concerns, patient's and family wishes, hospital costs, patient's age and level of dementia and physician's religion). Results—Swedish physicians chose fewer life-prolonging interventions as compared with the Russian and the German doctors. Swedish physicians would perform cardiopulmonary resuscitation (CPR) in the event of a cardiac arrest less frequently, followed by the German doctors. More than half the Russian physicians decided to perform CPR irrespective of the available information about the patient's wishes. Level of dementia emerged as the most powerful determining attitude-variable for the decision making in all three countries. Conclusions—The lack of compliance with patient wishes among a substantial number of doctors points to the necessity of emphasising ethical aspects both in medical education and clinical practice. The inconsistency in the treatment decisions of doctors from different countries calls for social consensus in this matter. Article in Journal/Newspaper Arkhangelsk The BMJ Canada Molloy ENVELOPE(70.065,70.065,-49.360,-49.360) Journal of Medical Ethics 27 3 186 191 |
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English |
description |
Objectives—The study was performed in order to investigate how end-of-life decisions are influenced by cultural and sociopolitical circumstances and to explore the compliance of doctors with patient wishes Participants and measurement—Five hundred and thirty-five physicians were surveyed in Sweden (Umeå), Germany (Rostock and Neubrandenburg), and in Russia (Arkhangelsk) by a questionnaire. The participants were recruited according to availability and are not representative. The questionnaire is based on the one developed by Molloy and co-workers in Canada which contains three case vignettes about an 82-year-old Alzheimer patient with an acute life-threatening condition; the questionnaire includes different levels of information about his treatment wishes. We have added various questions about attitudes determining doctors' decision making process (legal and ethical concerns, patient's and family wishes, hospital costs, patient's age and level of dementia and physician's religion). Results—Swedish physicians chose fewer life-prolonging interventions as compared with the Russian and the German doctors. Swedish physicians would perform cardiopulmonary resuscitation (CPR) in the event of a cardiac arrest less frequently, followed by the German doctors. More than half the Russian physicians decided to perform CPR irrespective of the available information about the patient's wishes. Level of dementia emerged as the most powerful determining attitude-variable for the decision making in all three countries. Conclusions—The lack of compliance with patient wishes among a substantial number of doctors points to the necessity of emphasising ethical aspects both in medical education and clinical practice. The inconsistency in the treatment decisions of doctors from different countries calls for social consensus in this matter. |
format |
Article in Journal/Newspaper |
author |
Richter, Jörg Eisemann, Martin Zgonnikova, Elena |
spellingShingle |
Richter, Jörg Eisemann, Martin Zgonnikova, Elena Doctors' authoritarianism in end-of-life treatment decisions. A comparison between Russia, Sweden and Germany |
author_facet |
Richter, Jörg Eisemann, Martin Zgonnikova, Elena |
author_sort |
Richter, Jörg |
title |
Doctors' authoritarianism in end-of-life treatment decisions. A comparison between Russia, Sweden and Germany |
title_short |
Doctors' authoritarianism in end-of-life treatment decisions. A comparison between Russia, Sweden and Germany |
title_full |
Doctors' authoritarianism in end-of-life treatment decisions. A comparison between Russia, Sweden and Germany |
title_fullStr |
Doctors' authoritarianism in end-of-life treatment decisions. A comparison between Russia, Sweden and Germany |
title_full_unstemmed |
Doctors' authoritarianism in end-of-life treatment decisions. A comparison between Russia, Sweden and Germany |
title_sort |
doctors' authoritarianism in end-of-life treatment decisions. a comparison between russia, sweden and germany |
publisher |
BMJ |
publishDate |
2001 |
url |
http://dx.doi.org/10.1136/jme.27.3.186 https://syndication.highwire.org/content/doi/10.1136/jme.27.3.186 |
long_lat |
ENVELOPE(70.065,70.065,-49.360,-49.360) |
geographic |
Canada Molloy |
geographic_facet |
Canada Molloy |
genre |
Arkhangelsk |
genre_facet |
Arkhangelsk |
op_source |
Journal of Medical Ethics volume 27, issue 3, page 186-191 ISSN 0306-6800 1473-4257 |
op_doi |
https://doi.org/10.1136/jme.27.3.186 |
container_title |
Journal of Medical Ethics |
container_volume |
27 |
container_issue |
3 |
container_start_page |
186 |
op_container_end_page |
191 |
_version_ |
1802641961455190016 |