Physicians' psychosocial barriers to different modes of withdrawal of life support in critical care: A qualitative study in Japan

Social Science & Medicine
Kaoruko Aita, Ichiro Kai

Abstract

Despite a number of guidelines issued in Anglo-American countries over the past few decades for forgoing treatment stating that there is no ethically relevant difference between withholding and withdrawing life-sustaining treatments (LST), it is recognized that many healthcare professionals in Japan as well as some of their western counterparts do not agree with this statement. This research was conducted to investigate the barriers that prevent physicians from withdrawing specific LST in critical care settings, focusing mainly on the modes of withdrawal of LST, in what the authors believe was the first study of its kind anywhere in the world. In 2006-2007, in-depth, face-to-face, semistructured interviews were conducted with 35 physicians working at emergency and critical care facilities across Japan. We elicited their experiences, attitudes, and perceptions regarding withdrawal of mechanical ventilation and other LST. The process of data analysis followed the grounded theory approach. We found that the psychosocial resistance of physicians to withdrawal of artificial devices varied according to the modes of withdrawal, showing a strong resistance to withdrawal of mechanical ventilation that requires physicians to halt the tre...Continue Reading

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Citations

Jan 5, 2016·Journal of Religion and Health·Grace S ChungFarr A Curlin
Apr 10, 2016·Intensive Care Medicine·James DownarLisa Kenny
May 17, 2019·Archives of Disease in Childhood. Fetal and Neonatal Edition·Jun ShibasakiUNKNOWN Baby Cooling Registry of Japan Collaboration Team
Jan 20, 2018·Current Opinion in Anaesthesiology·Wai-Tat WongGavin M Joynt
Mar 16, 2016·Thorax·A Craig DavidsonUNKNOWN BTS Standards of Care Committee Member, British Thoracic Society/Intensive Care Society Acute Hypercapnic Respiratory Failur
Nov 26, 2020·Philosophy, Ethics, and Humanities in Medicine : PEHM·Joshua Tze Yin KuekLalit Kumar Radha Krishna

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