• Edouard Ferrand, François Lemaire, Bernard Regnier, Khaldoun Kuteifan, Michel Badet, Pierre Asfar, Samir Jaber, Jean-Luc Chagnon, Anne Renault, René Robert, Frédéric Pochard, Christian Herve, Christian Brun-Buisson, Philippe Duvaldestin, and French RESSENTI Group.
• Unité de Réanimation Chirurgicale et Traumatologique, Service d'Anesthésie-Réanimation, Hôpital Henri-Mondor, AP-HP, 51 rue du Mal de Lattre de Tassigny, 94010 Créteil cedex, France. edouard.ferrand@hmn.ap-hop-paris.fr
• Am. J. Respir. Crit. Care Med. 2003 May 15;167(10):1310-5.

AbstractSeveral studies have pointed out ethical shortcomings in the decision-making process for withholding or withdrawing life-supporting treatments. We conducted a study to evaluate the perceptions of all caregivers involved in this process in the intensive care unit. A closed-ended questionnaire was completed by 3,156 nursing staff members and 521 physicians from 133 French intensive care units (participation rate, 42%). Decision-making processes were perceived as satisfactory by 73% of physicians and by only 33% of the nursing staff. More than 90% of caregivers believed that decision-making should be collaborative, but 50% of physicians and only 27% of nursing staff members believed that the nursing staff was actually involved (p < 0.001). Fear of litigation was a reason given by physicians for modifying information given to competent patients, families, and nursing staff. Perceptions by nursing staff may be a reliable indicator of the quality of medical decision-making processes and may serve as a simple and effective tool for evaluating everyday practice. Recommendations and legislation may help to build consensus and avoid conflicts among caregivers at each step of the decision-making process.

26 keywords...

hide…