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Open AccessArticle

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

by Sheng-Yu Fan 1,* and Jyh-Gang Hsieh 2,3
1
Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
2
Department of Medical Humanities, Tzu Chi University, Hualien 970, Taiwan
3
Heart Lotus Hospice, Hualien Tzu Chi Hospital, Hualien 970, Taiwan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(18), 6869; https://doi.org/10.3390/ijerph17186869
Received: 28 August 2020 / Revised: 17 September 2020 / Accepted: 18 September 2020 / Published: 20 September 2020
(This article belongs to the Section Health Care Sciences & Services)
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. View Full-Text
Keywords: cardiopulmonary resuscitation; do not resuscitate; end-of-life care; physicians; patient–doctor communication cardiopulmonary resuscitation; do not resuscitate; end-of-life care; physicians; patient–doctor communication
MDPI and ACS Style

Fan, S.-Y.; Hsieh, J.-G. The Experience of Do-Not-Resuscitate Orders and End-of-Life Care Discussions among Physicians. Int. J. Environ. Res. Public Health 2020, 17, 6869.

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