Exploring end-of-life decision-making in China for disorders of consciousness.
| Autor: | Li M; International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.; Intensive Care Unite, Hangzhou First People's Hospital, Hangzhou, China., Cecconi B; Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.; Centre du Cerveau2, University Hospital of Liège, Liège, Belgium., Gosseries O; Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.; Centre du Cerveau2, University Hospital of Liège, Liège, Belgium., Cheng L; International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China., Yan Y; School of Public Health, Zhejiang University, Hangzhou, China., Chen Y; International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.; School of Basic Medicine, Hangzhou Normal University, Hangzhou, China., Li Y; International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.; School of Basic Medicine, Hangzhou Normal University, Hangzhou, China., Laureys S; Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.; Centre du Cerveau2, University Hospital of Liège, Liège, Belgium.; Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Laval University, Québec, Canada., Di H; International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.; School of Basic Medicine, Hangzhou Normal University, Hangzhou, China. |
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| Jazyk: | angličtina |
| Zdroj: | Annals of medicine [Ann Med] 2024 Dec; Vol. 56 (1), pp. 2423794. Date of Electronic Publication: 2024 Nov 25. |
| DOI: | 10.1080/07853890.2024.2423794 |
| Abstrakt: | Objectives: We aim to investigate the ethical attitudes of the Chinese population toward withdrawal of life-sustaining treatment (WLST) in disorders of consciousness (DoC) patients. Methods: A self-administered questionnaire concerning WLST was distributed to Chinese medical professionals and non-medical participants between February and July 2022. Statistical analysis included chi-square tests and logistic regressions. Results: A total of 1223 Chinese participants responded to the questionnaire (39% of whom were medical professionals). Less than one third of participants reported positive attitudes towards withdrawing artificial nutrition and hydration (ANH), antibiotics, and do-not-resuscitation (DNR) orders in patients with unresponsive wakefulness syndrome (UWS) (30%, 24%, 24%) and minimally conscious state (MCS) (23%, 19%, 15%). More respondents agreed with WLST in UWS compared to MCS ( p < 0.05). Positive attitudes toward DNR orders were associated with participants' older age, religion, monthly income > 5000 RMB and medical profession ( p < 0.05). Most participants deemed patient's will (78%), families' wishes (67%), and financial burden (63%) to be crucial factors when considering WLST. Conclusions: Chinese respondents exhibit a relatively low propensity to accept WLST in DoC. Ethical attitudes toward WLST resulted to be affected by individual characteristics of responders. These results call for developing better regulations for identifying qualified surrogate decision-makers and reducing legal ambiguities. |
| Databáze: | MEDLINE |
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