Physicians' and nurses' preferences in using life-sustaining treatments

Area of Science:

• Medical Ethics
• Geriatric Medicine
• Palliative Care

Background:

• Severely ill elderly patients often require complex medical decisions regarding life-sustaining treatments (LST).
• Understanding healthcare professionals' preferences and influencing factors is crucial for ethical care.
• Existing research has not fully explored the nuances of LST preferences in diverse severe health conditions among the elderly.

Purpose of the Study:

• To investigate physicians' and nurses' preferences for using LST in elderly patients with severe conditions.
• To identify patient- and social-centered factors influencing these treatment preferences.
• To explore how professional orientation and personal values shape LST decisions.

Main Methods:

• Cross-sectional study utilizing structured questionnaires administered to physicians and nurses in Israeli general hospitals.
• Inquiry into preferences for LST in three distinct severe health conditions: metastatic cancer, mental illness, and being bedridden/incontinent.
• Assessment of influencing factors, including patient wishes, quality of life, religiosity, and legal considerations.

Main Results:

• Both physicians and nurses indicated a preference for using fewer LST for patients with metastatic cancer compared to those with mental illness or being bedridden/incontinent.
• Patient condition was a significant factor, but professional orientations and personal values also demonstrably influenced LST preferences.
• Factors such as patients' wishes, perceived quality of life, religiosity, and legal frameworks were considered influential.

Conclusions:

• Healthcare professionals' LST preferences are shaped by a complex interplay of clinical status, personal values, and professional perspectives.
• Open communication among healthcare professionals is essential for clarifying diverse beliefs and improving decision-making processes for LST.
• Addressing these multifaceted influences can enhance care for severely ill elderly patients and support their families.