The attitude of Brazilian intensive care physicians towards the decisions of withdrawal or withholding treatments

Introduction

The decision to forgo life-sustaining treatment is among the most challenging problems that physicians and patients face.

Objective

To examine the attitudes of the critical care physicians regarding the end-of-life decisions.

Design

An anonymous questionnaire was given to the physicians who participated in the National Congress of the Brazilian Society of Critical Care Medicine.

Results

A total of 82 questionnaires were answered. The majority of those who answered the questionnaire (94%) had withheld and withdrawn life-sustaining medical treatment. Decisions were more commonly made by physicians, and the younger physicians were more likely to admit patients with no survival expectancy. Dialysis was the therapy most frequently withheld and withdrawn. Sedation or analgesia were less frequently withheld or withdrawn. The most frequently factors taken under consideration for nonadmission into the intensive care were diagnosis and prognosis. To ensure comfort to the patient with no survival expectancy is the most important factor in his admission into an ICU.

Conclusions

Despite the discomfort in forgoing treatment, the majority of critical care professionals have been discussing forgoing treatment in irreversible, terminally ill patients. It is a serious ethical matter that needs to be studied.