Physicians' attitudes toward end-of-life decisions in amyotrophic lateral sclerosis

Amyotrophic Lateral Sclerosis & Frontotemporal Degeneration
Tamara ThurnJohanna Anneser

Abstract

This study aims (1) to assess physicians' attitudes toward different palliative end-of-life (EOL) practices in amyotrophic lateral sclerosis (ALS) care, including forgoing artificial nutrition and hydration (FANH), continuous sedation until death (CSD), and withdrawing invasive ventilation (WIV), and toward physician-assisted dying (PAD) including physician-assisted suicide and euthanasia and (2) to explore variables influencing these attitudes. We used two clinical vignettes depicting ALS patients in different stages of their disease progression to assess the influence of suffering (physical/psycho-existential) on attitudes toward WIV and the influence of suffering and prognosis (short-term/long-term) on attitudes toward FANH, CSD, and PAD. 50 physicians from European ALS centers and neurological departments completed our survey. Short-term prognosis had a positive impact on attitudes toward offering FANH (p = 0.014) and CSD (p = 0.048) as well as on attitudes toward performing CSD (p = 0.036) and euthanasia (p = 0.023). Predominantly psycho-existential suffering was associated with a more favorable attitude toward WIV but influenced attitudes toward performing CSD negatively. Regression analysis showed that religiosity was as...Continue Reading

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Citations

May 28, 2020·Expert Opinion on Emerging Drugs·Andrea BarpChristian Lunetta
Jan 6, 2021·BMJ Supportive & Palliative Care·Anke ErdmannGerald Neitzke
Apr 4, 2021·Brain Sciences·Luigi LavorgnaSimona Bonavita

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