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The Experience of Do-Not-Resuscitate Orders and End-of-Life Care Discussions among Physicians

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  • Sheng-Yu Fan

    (Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan)

  • Jyh-Gang Hsieh

    (Department of Medical Humanities, Tzu Chi University, Hualien 970, Taiwan
    Heart Lotus Hospice, Hualien Tzu Chi Hospital, Hualien 970, Taiwan)

Abstract

Physicians have a responsibility to discuss do-not-resuscitate (DNR) decisions and end-of-life (EOL) care with patients and family members. The aim of this study was to explore the DNR and EOL care discussion experience among physicians in Taiwan. A qualitative study was conducted with 16 physicians recruited from the departments of hospice care, surgery, internal medicine, emergency, and the intensive care unit. The interview guidelines included their DNR experience and process and EOL care discussions, as well as their concerns, difficulties, or worries in discussions. Thematic analysis was used to analyze data. Four themes were identified. First, family members had multiple roles in the decision process. Second, the characteristics of the units, including time urgency and relationships with patients and family members, influenced physicians’ work. Third, the process included preparation, exploration, information delivery, barrier solution, and execution. Fourth, physicians shared reflections on their ability and the conflicts between law, medical professionals, and the best interests of patients. Physicians must consider not only patients’ but also family members’ opinions and surmount several barriers in decision-making. They also experienced negative and positive impacts from these discussions.

Suggested Citation

  • Sheng-Yu Fan & Jyh-Gang Hsieh, 2020. "The Experience of Do-Not-Resuscitate Orders and End-of-Life Care Discussions among Physicians," IJERPH, MDPI, vol. 17(18), pages 1-10, September.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:18:p:6869-:d:416359
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    References listed on IDEAS

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    1. Epstein, Ronald M. & Franks, Peter & Fiscella, Kevin & Shields, Cleveland G. & Meldrum, Sean C. & Kravitz, Richard L. & Duberstein, Paul R., 2005. "Measuring patient-centered communication in Patient-Physician consultations: Theoretical and practical issues," Social Science & Medicine, Elsevier, vol. 61(7), pages 1516-1528, October.
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    1. Hui-Mei Lin & Chih-Kuang Liu & Yen-Chun Huang & Chieh-Wen Ho & Mingchih Chen, 2021. "Investigating Key Factors Related to the Decision of a Do-Not-Resuscitate Consent," IJERPH, MDPI, vol. 19(1), pages 1-9, December.

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