Variation in end-of-life decision making between critical care consultants

Area of Science:

• Medical Ethics
• Intensive Care Medicine
• Psychology

Background:

• End-of-life decision-making (ELDM) in intensive care units (ICUs) shows significant variation across the UK, potentially due to patient case mix.
• Consistency in ELDM among senior medical staff within a single unit is expected but not always observed.

Purpose of the Study:

• To assess the consistency of end-of-life decision-making among consultants within a specific intensive care unit.
• To explore potential influencing factors, such as personality traits, on the willingness to make these decisions.

Main Methods:

• Retrospective review of medical records over a 4-year period.
• Analysis of end-of-life decision-making patterns among attending consultants.
• Application of the Myers-Briggs Type Indicator (MBTI) personality assessment to consultants.

Main Results:

• Significant variation was observed in the frequency of end-of-life decisions made by different consultants.
• The data suggests a subjective element influencing consultants' willingness to make end-of-life decisions.
• Consultants who made more end-of-life decisions than expected scored higher on the 'judging' aspect of the Myers-Briggs Type Indicator.

Conclusions:

• End-of-life decision-making in intensive care is influenced by individual consultant factors, including personality.
• The subjective nature of these decisions warrants further investigation into standardization and training.
• Understanding personality influences may aid in improving consistency and quality of care at the end of life.