Physician characteristics associated with decisions to withdraw life support

Am J Public Health. 1995 Mar;85(3):367-72. doi: 10.2105/ajph.85.3.367.

Abstract

Objective: This study was undertaken to identify attributes of physicians associated with physicians' decisions to withdraw life support.

Methods: Of the 862 Pennsylvania internists surveyed and asked to make decisions in response to hypothetical vignettes and to report their actual experience with the withdrawal of life support, 485 (56%) responded. The data were analyzed with regression models.

Results: With other factors controlled, physicians were more willing to withdraw life support if they were young, practiced in a tertiary care setting, or spent more time in clinical practice; they were less willing if they were Catholic or Jewish. Physicians reported a higher frequency of actually withdrawing life support if they were young, had more contact with ICU patients, spent more time in clinical practice, or were specialists. Physicians with a greater willingness to withdraw were more likely to report having done so.

Conclusions: Physicians' personal characteristics are associated with both their preferences and their practice in the withdrawal of life support, and a greater willingness to withdraw is associated with a higher frequency of withdrawal. The influence of physician characteristics demonstrates that patient preferences and clinical circumstances do not exclusively govern such ethical decisions.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Attitude of Health Personnel*
  • Decision Making*
  • Ethics, Medical
  • Euthanasia, Passive*
  • Female
  • Humans
  • Life Support Care / statistics & numerical data*
  • Logistic Models
  • Male
  • Medicine
  • Philadelphia
  • Physician-Patient Relations
  • Physicians / psychology*
  • Physicians / statistics & numerical data
  • Poisson Distribution
  • Religion
  • Specialization
  • Withholding Treatment*