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    Life and death decisions for incompetent patients: determining best interests--the Irish perspective.

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    Authors
    Armstrong, K
    Ryan, C A
    Hawkes, C P
    Janvier, A
    Dempsey, E M
    Affiliation
    Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland.
    Issue Date
    2011-04
    MeSH
    Adolescent
    Adult
    Age Factors
    Aged, 80 and over
    Attitude of Health Personnel
    Child
    Decision Making
    Humans
    Infant
    Infant, Newborn
    Infant, Premature
    Ireland
    Life Support Care
    Mental Competency
    Middle Aged
    Neonatology
    Obstetrics
    Pediatrics
    Physician's Practice Patterns
    Physician-Patient Relations
    Resuscitation
    Students, Medical
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    Citation
    Life and death decisions for incompetent patients: determining best interests--the Irish perspective. 2011, 100 (4):519-23 Acta Paediatr.
    Journal
    Acta paediatrica (Oslo, Norway : 1992)
    URI
    http://hdl.handle.net/10147/136382
    DOI
    10.1111/j.1651-2227.2010.02084.x
    PubMed ID
    21070357
    Additional Links
    http://www.ncbi.nlm.nih.gov/pubmed/21070357
    Abstract
    To determine whether healthcare providers apply the best interest principle equally to different resuscitation decisions.
    An anonymous questionnaire was distributed to consultants, trainees in neonatology, paediatrics, obstetrics and 4th medical students. It examined resuscitation scenarios of critically ill patients all needing immediate resuscitation. Outcomes were described including survival and potential long-term sequelae. Respondents were asked whether they would intubate, whether resuscitation was in the patients best interest, would they accept surrogate refusal to initiate resuscitation and in what order they would resuscitate.
    The response rate was 74%. The majority would wish resuscitation for all except the 80-year-old. It was in the best interest of the 2-month-old and the 7-year-old to be resuscitated compared to the remaining scenarios (p value <0.05 for each comparison). Approximately one quarter who believed it was in a patient best interests to be resuscitated would nonetheless accept the family refusing resuscitation. Medical students were statistically more likely to advocate resuscitation in each category.
    These results suggest resuscitation is not solely related to survival or long-term outcome and the best interest principle is applied differently, more so at the beginning of life.
    Item Type
    Article
    Language
    en
    ISSN
    1651-2227
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1651-2227.2010.02084.x
    Scopus Count
    Collections
    Cork University Maternity Hospital

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