Department of Neonatology, Women & Children's Division, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
Pediatr Crit Care Med. 2013 Feb;14(2):e63-9. doi: 10.1097/PCC.0b013e31826e73f1.
To study the attitudes of Norwegian physicians to resuscitation of hypothetical patients all at risk of neurological sequelae.
Mail-based survey.
A cohort of Norwegian physicians who are representative of the national physician corps.
A total of 1650 Norwegian physicians (7% of practicing physicians in Norway) received a written questionnaire describing six scenarios of patients all in need of emergency life-saving intervention. Respondents were asked whether they would resuscitate; whether such resuscitation was in the patient's best interest; whether a surrogate's refusal of intervention would be accepted; and whether they would have wanted resuscitation if the patient were their own child, their spouse, or themselves. Positive or negative responses on a four-point Likert scale were recorded.
A total of 1,069 respondents (response rate, 65%). Physicians responding to these scenarios were a) more inclined to resuscitate an anonymous patient than if the patient were themselves or their kin; b) willing to resuscitate although they do not consider this intervention to be in the patient's best interest; c) willing to refrain from resuscitation on surrogate request in spite of a reasonably good prognosis; d) willing to accept surrogate's refusal of resuscitation in spite of a stated opinion that such intervention would be in the patient's best interest; and e) less willing to resuscitate newborn infants compared with older children and adults (except the aged) with similar prognoses.
There appear to be differences in medical thinking about best interest, surrogate decision making, and the relative value of lives as far as these are applied to acute, life-saving treatment.
研究挪威医生对可能存在神经后遗症风险的假设患者进行复苏的态度。
基于邮件的调查。
具有代表性的挪威医生队列，代表全国医生队伍。
总共向 1650 名挪威医生（挪威执业医生的 7%）发送了一份书面问卷，描述了六种需要紧急救生干预的患者情况。要求受访者回答是否会进行复苏；这种复苏是否符合患者的最佳利益；是否会接受代理人拒绝干预；如果患者是他们自己的孩子、配偶或自己，他们是否会希望进行复苏。记录了四点李克特量表上的阳性或阴性反应。
共有 1069 名受访者（回应率为 65%）。对于这些情况，医生的反应是：a）更倾向于对匿名患者进行复苏，而不是对自己或亲属进行复苏；b）即使他们不认为这种干预符合患者的最佳利益，也愿意进行复苏；c）尽管有相当好的预后，但愿意根据代理人的要求不进行复苏；d）愿意接受代理人拒绝复苏的请求，尽管他们表示这种干预符合患者的最佳利益；e）与预后相似的年长儿童和成人（除老年人外）相比，新生儿复苏的意愿较低。
在考虑最佳利益、代理人决策以及对急性救生治疗的生命相对价值方面，医学思维似乎存在差异。
