Are medical ethicists out of touch? Practitioner attitudes in the US and UK towards decisions at the end of life
Objectives—To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effect Design, subjects and setting–A 138-item attitudinal questionnaire c...
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description | Objectives—To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effect Design, subjects and setting–A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on “Death and Dying” was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on “Decisions near the End of Life”. Results–Practitioners accept the relevance of concepts widely disparaged by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/ withdrawing treatment. Within the UK nurses' group a “rationalist” axis of respondents who describe themselves as having “no religion” are closer to the bioethics consensus on withholding and withdrawing treatment. Conclusions—Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners. |
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Practitioner attitudes in the US and UK towards decisions at the end of life</title><source>MEDLINE</source><source>Periodicals Index Online</source><source>JSTOR Archive Collection A-Z Listing</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Dickenson, Donna L</creator><creatorcontrib>Dickenson, Donna L</creatorcontrib><description>Objectives—To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effect Design, subjects and setting–A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on “Death and Dying” was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on “Decisions near the End of Life”. Results–Practitioners accept the relevance of concepts widely disparaged by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/ withdrawing treatment. Within the UK nurses' group a “rationalist” axis of respondents who describe themselves as having “no religion” are closer to the bioethics consensus on withholding and withdrawing treatment. Conclusions—Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners.</description><identifier>ISSN: 0306-6800</identifier><identifier>EISSN: 1473-4257</identifier><identifier>DOI: 10.1136/jme.26.4.254</identifier><identifier>PMID: 10951920</identifier><identifier>CODEN: JMETDR</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and Institute of Medical Ethics</publisher><subject>Attitude of Health Personnel ; Attitude to Death ; Attitudes ; Bioethics ; Death ; Death & dying ; Death and dying ; Decision Making ; Double effect ; Double Effect Principle ; Ethicists ; Ethics ; Ethics, Medical ; Euthanasia ; Euthanasia, Active ; Futile medical care ; Hospitals ; Humans ; Intention ; Internationality ; Life Support Care - standards ; Life Support Care - statistics & numerical data ; Medical ethics ; Medical Futility ; Morality ; Morals ; Motivation ; Nurses ; Nurses - psychology ; Nurses - statistics & numerical data ; Patient care ; Philosophers ; Physicians ; Physicians - psychology ; Physicians - statistics & numerical data ; Questionnaires ; refusal of treatment ; Social Values ; Surveys and Questionnaires ; Terminal Care - standards ; United Kingdom ; United States ; withdrawal of care ; Withdrawal of treatment ; Withholding Treatment ; Writers</subject><ispartof>Journal of medical ethics, 2000-08, Vol.26 (4), p.254-260</ispartof><rights>Copyright 2000 by the Journal of Medical Ethics</rights><rights>Copyright 2000 Journal of Medical Ethics</rights><rights>COPYRIGHT 2000 BMJ Publishing Group Ltd.</rights><rights>COPYRIGHT 2000 BMJ Publishing Group Ltd.</rights><rights>Copyright: 2000 Copyright 2000 by the Journal of Medical Ethics</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b673t-7be9010e6d7a038f5277e1363530cdd535a8897fd173baa33fdb0c6d8b5ad88b3</citedby><cites>FETCH-LOGICAL-b673t-7be9010e6d7a038f5277e1363530cdd535a8897fd173baa33fdb0c6d8b5ad88b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/27718534$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/27718534$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,314,727,780,784,803,885,27869,27924,27925,53791,53793,58017,58250</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10951920$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dickenson, Donna L</creatorcontrib><title>Are medical ethicists out of touch? Practitioner attitudes in the US and UK towards decisions at the end of life</title><title>Journal of medical ethics</title><addtitle>J Med Ethics</addtitle><description>Objectives—To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effect Design, subjects and setting–A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on “Death and Dying” was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on “Decisions near the End of Life”. Results–Practitioners accept the relevance of concepts widely disparaged by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/ withdrawing treatment. Within the UK nurses' group a “rationalist” axis of respondents who describe themselves as having “no religion” are closer to the bioethics consensus on withholding and withdrawing treatment. Conclusions—Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners.</description><subject>Attitude of Health Personnel</subject><subject>Attitude to Death</subject><subject>Attitudes</subject><subject>Bioethics</subject><subject>Death</subject><subject>Death & dying</subject><subject>Death and dying</subject><subject>Decision Making</subject><subject>Double effect</subject><subject>Double Effect Principle</subject><subject>Ethicists</subject><subject>Ethics</subject><subject>Ethics, Medical</subject><subject>Euthanasia</subject><subject>Euthanasia, Active</subject><subject>Futile medical care</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intention</subject><subject>Internationality</subject><subject>Life Support Care - standards</subject><subject>Life Support Care - statistics & numerical data</subject><subject>Medical ethics</subject><subject>Medical Futility</subject><subject>Morality</subject><subject>Morals</subject><subject>Motivation</subject><subject>Nurses</subject><subject>Nurses - psychology</subject><subject>Nurses - statistics & numerical data</subject><subject>Patient care</subject><subject>Philosophers</subject><subject>Physicians</subject><subject>Physicians - psychology</subject><subject>Physicians - statistics & numerical data</subject><subject>Questionnaires</subject><subject>refusal of treatment</subject><subject>Social Values</subject><subject>Surveys and Questionnaires</subject><subject>Terminal Care - standards</subject><subject>United Kingdom</subject><subject>United States</subject><subject>withdrawal of care</subject><subject>Withdrawal of treatment</subject><subject>Withholding Treatment</subject><subject>Writers</subject><issn>0306-6800</issn><issn>1473-4257</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>K30</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AVQMV</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>K50</sourceid><sourceid>M1D</sourceid><sourceid>M2O</sourceid><recordid>eNp90lFv0zAQB_AIgdgovPEKsoQEPCzFjuPYfQFNBQqibJPG4NFy4kvrksbFdmB8e250Ghuqljwkyv108l3-WfaY0TFjvHq1WsO4qMbluBDlnWyflZLnZSHk3WyfclrllaJ0L3sQ44riVajJ_WyP0Ylgk4LuZ5vDAGQN1jWmI5CWrnExReKHRHxLkh-a5RtyEkyTXHK-h0BMwtfBQiSuJ2kJ5OyUmN6Ss0_If5lgI7GAXVBHxH8JYB3bda6Fh9m91nQRHl0-R9nZ-3dfph_y-fHs4_RwnteV5CmXNUwoo1BZaShXrSikBByXC04bawUXRqmJbC2TvDaG89bWtKmsqoWxStV8lL3e9t0MNc7XQJ-C6fQmuLUJv7U3Tt-s9G6pF_6nxoa8KCts8PyyQfA_BohJr11soOtMD36IWjJZUVoWCJ_9B1d-CD0Oh70UY2xSCXm7ElQpwXC2UXawVQvTgXZ96_FszQJw8abD9bcOPx9WuA1V0gue7-B4W1i7Zpd_ecMjSXCeFmaIUavZ_AY92EUb33WwAI3_anq8izfBxxigvdo0o_oipxpzqotKlxpzivzp9b9zDW-DieDJFqxi8uGqjilgSvDy3-QYVzi_qpvwXWN-pNBHX6f6aH7y9tvnGdWn6F9sfb1e3X60P0enBl0</recordid><startdate>20000801</startdate><enddate>20000801</enddate><creator>Dickenson, Donna L</creator><general>BMJ Publishing Group Ltd and Institute of Medical Ethics</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group Ltd</general><general>Society for the Study of Medical Ethics</general><general>BMJ Publishing Group LTD</general><general>BMJ Group</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8GL</scope><scope>HFIND</scope><scope>IOIBA</scope><scope>K30</scope><scope>PAAUG</scope><scope>PAWHS</scope><scope>PAWZZ</scope><scope>PAXOH</scope><scope>PBHAV</scope><scope>PBQSW</scope><scope>PBYQZ</scope><scope>PCIWU</scope><scope>PCMID</scope><scope>PCZJX</scope><scope>PDGRG</scope><scope>PDWWI</scope><scope>PETMR</scope><scope>PFVGT</scope><scope>PGXDX</scope><scope>PIHIL</scope><scope>PISVA</scope><scope>PJCTQ</scope><scope>PJTMS</scope><scope>PLCHJ</scope><scope>PMHAD</scope><scope>PNQDJ</scope><scope>POUND</scope><scope>PPLAD</scope><scope>PQAPC</scope><scope>PQCAN</scope><scope>PQCMW</scope><scope>PQEME</scope><scope>PQHKH</scope><scope>PQMID</scope><scope>PQNCT</scope><scope>PQNET</scope><scope>PQSCT</scope><scope>PQSET</scope><scope>PSVJG</scope><scope>PVMQY</scope><scope>PZGFC</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>88J</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>AABKS</scope><scope>ABSDQ</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AVQMV</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K50</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1D</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>M2R</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20000801</creationdate><title>Are medical ethicists out of touch? Practitioner attitudes in the US and UK towards decisions at the end of life</title><author>Dickenson, Donna L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b673t-7be9010e6d7a038f5277e1363530cdd535a8897fd173baa33fdb0c6d8b5ad88b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Attitude of Health Personnel</topic><topic>Attitude to Death</topic><topic>Attitudes</topic><topic>Bioethics</topic><topic>Death</topic><topic>Death & dying</topic><topic>Death and dying</topic><topic>Decision Making</topic><topic>Double effect</topic><topic>Double Effect Principle</topic><topic>Ethicists</topic><topic>Ethics</topic><topic>Ethics, Medical</topic><topic>Euthanasia</topic><topic>Euthanasia, Active</topic><topic>Futile medical care</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intention</topic><topic>Internationality</topic><topic>Life Support Care - standards</topic><topic>Life Support Care - statistics & numerical data</topic><topic>Medical ethics</topic><topic>Medical Futility</topic><topic>Morality</topic><topic>Morals</topic><topic>Motivation</topic><topic>Nurses</topic><topic>Nurses - psychology</topic><topic>Nurses - statistics & numerical data</topic><topic>Patient care</topic><topic>Philosophers</topic><topic>Physicians</topic><topic>Physicians - psychology</topic><topic>Physicians - statistics & numerical data</topic><topic>Questionnaires</topic><topic>refusal of treatment</topic><topic>Social Values</topic><topic>Surveys and Questionnaires</topic><topic>Terminal Care - standards</topic><topic>United Kingdom</topic><topic>United States</topic><topic>withdrawal of care</topic><topic>Withdrawal of treatment</topic><topic>Withholding Treatment</topic><topic>Writers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dickenson, Donna L</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: High School</collection><collection>Periodicals Index Online Segment 16</collection><collection>Periodicals Index Online Segment 29</collection><collection>Periodicals Index Online</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of medical ethics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dickenson, Donna L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are medical ethicists out of touch? Practitioner attitudes in the US and UK towards decisions at the end of life</atitle><jtitle>Journal of medical ethics</jtitle><addtitle>J Med Ethics</addtitle><date>2000-08-01</date><risdate>2000</risdate><volume>26</volume><issue>4</issue><spage>254</spage><epage>260</epage><pages>254-260</pages><issn>0306-6800</issn><eissn>1473-4257</eissn><coden>JMETDR</coden><abstract>Objectives—To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effect Design, subjects and setting–A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on “Death and Dying” was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on “Decisions near the End of Life”. Results–Practitioners accept the relevance of concepts widely disparaged by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/ withdrawing treatment. Within the UK nurses' group a “rationalist” axis of respondents who describe themselves as having “no religion” are closer to the bioethics consensus on withholding and withdrawing treatment. Conclusions—Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and Institute of Medical Ethics</pub><pmid>10951920</pmid><doi>10.1136/jme.26.4.254</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Attitude of Health Personnel Attitude to Death Attitudes Bioethics Death Death & dying Death and dying Decision Making Double effect Double Effect Principle Ethicists Ethics Ethics, Medical Euthanasia Euthanasia, Active Futile medical care Hospitals Humans Intention Internationality Life Support Care - standards Life Support Care - statistics & numerical data Medical ethics Medical Futility Morality Morals Motivation Nurses Nurses - psychology Nurses - statistics & numerical data Patient care Philosophers Physicians Physicians - psychology Physicians - statistics & numerical data Questionnaires refusal of treatment Social Values Surveys and Questionnaires Terminal Care - standards United Kingdom United States withdrawal of care Withdrawal of treatment Withholding Treatment Writers |
title | Are medical ethicists out of touch? Practitioner attitudes in the US and UK towards decisions at the end of life |
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