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Physician beliefs and practice regarding end-of-life care in India

V Theodore Barnett¹, V K Aurora

¹The John A. Burns School of Medicine, The University of Hawaii, Honolulu, Hawaii, USA. tbarnett@mcw.edu

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine

|September 11, 2009

Abstract

Background And Aims:

Physician beliefs and practices largely determine the withdrawal of life support in intensive care units. No information exists regarding beliefs regarding the withdrawal of life support among physicians in India.

Materials And Methods:

We performed a questionnaire at the NAPCON conference in Jaipur.

Results:

One hundred and twenty-two questionnaires were completed and returned. The majority of respondents did not apply do not resuscitate orders. Most physicians stated withdrawal of life support was not allowed or practiced at their institution. Thirty-five percent of physicians stated they performed life-support withdrawal. Barriers to good end-of-life care were primarily legal but also included hospital policy and social constraints.

Conclusions:

Pulmonary and critical care physicians in India have a lower rate of withdrawal of life support than western physicians. The reasons seem to be primarily legal and policy related. Culture and religion were not identified as barriers. Clarification of the legal and policy status of withdrawal of life support is needed.

Keywords:

ICU life-support questionnaire

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