연명치료에 대한 충청지역 소재 종합병원 중환자실 담당의사의 의식조사

Abstract

The purpose of this study attempts to identify knowledge, opinions, and atiitudes on life-sustaining treatments of physicians in the ICU. The survey was done on 28 hospitals, at which 2 surveys were conducted. Analysis sample included 56 cases. All of respondents were physicians who were in charge of ICU. None of 28 hospitals had a document related to DNR orders. About 41% of respondents had an experience of oral communications on the subject of DNR orders with caregivers and/or patients. Results were as follows: 1) About 73% of respondents have some degree of knowledge about DNR orders. 2) None of 28 hospitals in the area of Chungchungnam-do, Chungchungbuk-do, and Daejeon-city had a document related to DNR orders. But, before the withdrawl of life-sustaining treatments, there has been communications among physicians, caregivers, and patients. 3) 53.6% of respondents had the experiences on the withdrawal of life-sustaining treatments, for this study, CPR. Primary caregivers played a prioritized role in the decision-making process of end-of-life care along with physicians in the ICU. In contrast, patients' role was reported to be minimal. In contrast with the Western countries, patients' right to decision didn't seem to be weighed much. Majority of respondents thought beginning of life-sustaining treatments too many but the withdrawal too few as they should be done on the basis of medical judgement. 4) Presumed that there is no chance of recovery, as for factors affecting physicians' decision on the withdrawal of life-sustaining treatments in the ICU, physician's medical judgement was the most frequent factor, caregivers' need the second. Patients' need was one of those factors which considered the least frequent.