Explaining the Process of Determining Futility Increases Lay Public Acceptance

Annals of the American Thoracic Society
Kunal BailoorDarin B Zahuranec

Abstract

Rationale: National guidelines have laid out a process to conflict resolution in cases of potentially inappropriate medical interventions. Objectives: To determine the association between information about a process-based approach and lay public perceptions of the appropriateness of withholding medically inappropriate interventions. Methods: Respondents from a nationwide sample completed a survey with two adult intensive care unit-based vignettes: one about advanced cancer where doctors told the family that additional chemotherapy would not be offered, and a second case of multiorgan failure after brain hemorrhage where dialysis would not be offered. Participants were randomly assigned to see or not see information about a detailed process for the determination to withhold (second opinion, ethics consultation, exploring transfer to another institution). The primary outcome was the perceived appropriateness of not providing the treatment (four-point scale, dichotomized for analysis, modified Poisson regression), and the secondary outcome was the negative emotional reaction to the case (positive and negative affect schedule, range 1-5, higher is greater negative emotional response, linear regression). Results: A total of 1,191 re...Continue Reading

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Citations

Jun 1, 2019·Annals of the American Thoracic Society·Gabriel T BossletAlison E Turnbull
Mar 17, 2020·American Journal of Respiratory and Critical Care Medicine·Yaseen M ArabiHasan M Al-Dorzi
Apr 30, 2020·Annals of the American Thoracic Society·Thanh H NevilleNeil S Wenger

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