Intensive Care Specialists’ Knowledge, Attitudes and Practice Relating to the Law About Withholding and Withdrawing Life-Sustaining Treatment: A Cross-Sectional Study

Critical Care and Resuscitation, 18(2), pp. 109-115.

Posted: 23 Nov 2016

See all articles by Ben White

Ben White

Queensland University of Technology - Faculty of Law

Lindy Willmott

Queensland University of Technology - Faculty of Law

Colleen Cartwright

Southern Cross University

Malcolm Parker

University of Queensland - School of Medicine

Gail Williams

University of Queensland

Date Written: 2016

Abstract

Objective: Decisions about life-sustaining treatment from adults who lack capacity are an integral part of intensive care (IC) practice. This paper compares Intensivists with six other specialties most often involved in end-of-life care as to their knowledge, attitudes and practice in relation to the law in this area.

Design: Cross-sectional postal survey of medical specialists.

Setting: Three largest Australian states by population.

Participants: 867 medical specialists from seven specialties most likely to be involved in end-of-life decision-making in the acute setting (emergency, geriatric, palliative, renal and respiratory medicine, medical oncology, and intensive care).

Main outcome measures: Attitudes to, and knowledge and practice of, law at the end of life.

Results: 867/2702 eligible completed questionnaires were returned, an overall response rate of 32% with an IC response rate also of 32% (125 from 388). Intensivists performed above average in terms of legal knowledge but important knowledge gaps remain. Intensivists had a more negative attitude to the role of law in this area than other specialty groups but reported being seen as a leading source of information about legal issues by other medical specialists and nurses. Intensivists also reported as being the specialty most frequently making decisions about end-of-life treatment.

Conclusions: Improved legal knowledge and open engagement with law can help manage the risk of harm to patients and to protect Intensivists from liability. IC guidelines and continuing professional development are important strategies to address these concerns.

Keywords: Health law, Medical law, Adult guardianship law, Withholding and withdrawing life-sustaining treatment, Intensive care, Knowledge of law, Compliance with law, Survey of doctors, End of life decision-making

Suggested Citation

White, Ben and Willmott, Lindy and Cartwright, Colleen and Parker, Malcolm and Williams, Gail, Intensive Care Specialists’ Knowledge, Attitudes and Practice Relating to the Law About Withholding and Withdrawing Life-Sustaining Treatment: A Cross-Sectional Study (2016). Critical Care and Resuscitation, 18(2), pp. 109-115.. Available at SSRN: https://ssrn.com/abstract=2874589

Ben White (Contact Author)

Queensland University of Technology - Faculty of Law ( email )

Level 4, C Block Gardens Point
2 George St
Brisbane, QLD 4000
Australia

HOME PAGE: http://staff.qut.edu.au/staff/whiteb/

Lindy Willmott

Queensland University of Technology - Faculty of Law ( email )

Level 4, C Block Gardens Point
2 George St
Brisbane, QLD 4000
Australia

HOME PAGE: http://staff.qut.edu.au/staff/willmott/

Colleen Cartwright

Southern Cross University ( email )

Lismore, New South Wales 2480
Australia

Malcolm Parker

University of Queensland - School of Medicine ( email )

St Lucia
Queensland 4072
Australia

Gail Williams

University of Queensland ( email )

St Lucia
Brisbane, Queensland 4072
Australia

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