Skip to main content

End-of life thoughts in the ICU: results of a survey

Introduction

The decision of terminal care in the ICU is a very tough issue because the law, ethics, traditions and futility should be concerned involving the family's will. Especially, stopping or withdrawing therapy is a quite difficult operation in Japan because of legal issues. Our hypothesis is that some difference exists in thoughts between physicians and nurses for terminal patients in the ICU. The aim of this study is to know their real thoughts.

Methods

A questionnaire survey was performed on physicians and nurses in our medico-surgical ICU. The questionnaire consists of 11 questions with five optional answers related to the thoughts of participants about treatment of hopeless or brain death patients. Concretely, the questions were; whether to withhold therapy or not, whether to accept to withdraw therapy or not and with family's will, whether to accept to immediately stop therapy and with family's will, whether to positively or not donate organs from a brain death patient, necessity of ICU care for brain death patients, and feeling guilty and stress for stopping or withdrawing therapy. The optional answer has five gradations from 'Yes' to 'No' for all questions. The participants were asked to answer the questionnaire by expressing themselves without regarding legal issues or the consensus. It was guaranteed to be anonymous for them in the data analysis. The answers were compared between physicians and nurses. The Mann-Whitney U test was used for statistical analysis. P 0.05 was considered statistically significant.

Results

There were in total 52 participants (response rate 98.1%) with 20 physicians and 32 nurses. Withdrawing therapy was significantly accepted in nurses than in physicians (83% vs. 55%, P = 0.039), when the family well understood. Withholding therapy should not be operated for brain death patients for physicians (65%), while it seemed a difficult judgement for nurses (23%, P = 0.021). ICU care for brain death patients is less necessary for physicians than nurses (80% vs. 53%, P = 0.016). There were no significant differences in other questions between physician and nurses such as feeling guilty or stress for stopping or withdrawing therapy.

Conclusion

Some of end-of-life thoughts in the ICU showed differences between physicians and nurses.

Author information

Affiliations

Authors

Corresponding author

Correspondence to A Yaguchi.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Yaguchi, A., Namiki, M., Saito, N. et al. End-of life thoughts in the ICU: results of a survey. Crit Care 17, P529 (2013). https://doi.org/10.1186/cc12467

Download citation

Keywords

  • Public Health
  • Data Analysis
  • Emergency Medicine
  • Questionnaire Survey
  • Brain Death