Damps Maria, Gajda Maksymilian, Wiktor Łukasz, Byrska-Maciejasz Elżbieta, Rybojad Beata, Kowalska Małgorzata, Bartkowska-Śniatkowska Alicja, Paprocka-Lipińska Anna, Kucewicz-Czech Ewa
Department of Anesthesiology and Intensive Care, Upper Silesian Child Health Centre, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
Eur J Public Health. 2025 Apr 1;35(2):201-208. doi: 10.1093/eurpub/ckae202.
The discontinuation of futile therapy is increasingly discussed in Polish clinical practice. Given the need to ensure patient well-being, it is essential to consider whether all clinical options resulting from medical progress should be used for every patient and on what grounds decisions to limit therapy should be based. The aim of our study was to determine the opinions of Polish medical doctors on this topic. We anonymously surveyed physicians across various specialties. An analysis of the collected data was carried out using descriptive and analytical methods. A total of 323 physicians participated in the study; 93% of them were aware of the problem of futile therapy in adults, with intensivists being significantly more aware (P = 0.002). Additionally, 95% of respondents supported the idea of discontinuing futile therapy, and over 68% used the therapy discontinuation protocol. Among the most common reasons for undertaking futile therapy, respondents cited fear of legal liability (93.5%), as well as fear of being accused of unethical behavior (62.2%) and fear before talking to the patient/patient's family and their reactions (57.9%). Respondents also identified factors that would facilitate making decisions about limiting futile therapy, including precise qualification criteria for limiting therapy and education in this area (95.3%), the patient's declaration of will (87.5%), and a clear legal act (81.3%). The majority of study participants supported the idea of limiting futile therapy, and this issue is well known among Polish physicians.
在波兰的临床实践中，关于停止无效治疗的讨论日益增多。鉴于需要确保患者的福祉，至关重要的是要考虑医学进步带来的所有临床选择是否应适用于每一位患者，以及限制治疗的决定应以何种依据为基础。我们研究的目的是确定波兰医生对这一主题的看法。我们对各个专业的医生进行了匿名调查。使用描述性和分析性方法对收集到的数据进行了分析。共有323名医生参与了这项研究；其中93%的人了解成人无效治疗的问题，重症监护医生的知晓率显著更高（P = 0.002）。此外，95%的受访者支持停止无效治疗的想法，超过68%的人使用了治疗终止方案。在进行无效治疗的最常见原因中，受访者提到了对法律责任的恐惧（93.5%），以及对被指控行为不道德的恐惧（62.2%）和在与患者/患者家属交谈前的恐惧及其反应（57.9%）。受访者还确定了有助于做出限制无效治疗决定的因素，包括限制治疗的精确资格标准和该领域的教育（95.3%）、患者的意愿声明（87.5%）以及明确的法律行为（81.3%)。大多数研究参与者支持限制无效治疗的想法，并且这个问题在波兰医生中广为人知。
