End-of-life confusion

Specialists appear unable to make competent end-of-life decisions involving the withholding and withdrawing of medical treatment, according a study published in the MJA.  

The study led by Ben White from the Queensland University of Technology shows a mean score of 3.26 out of seven in a knowledge test about the validity of an advance care directive (ACD) and the authority of substitute decision-makers.

Close to 900 specialists in emergency medicine, geriatric medicine, intensive care, medical oncology, palliative medicine, renal medicine and respiratory medicine took part and few were able to determine whether an ACD presented to them was valid.

Even if it was valid, the doctors were uncertain about whether they should follow a directive to refuse treatment in a situation when treatment was “clinically indicated”. They also lacked knowledge