Date of Award

7-1998

Document Type

Thesis

Degree Name

Master of Science (MS)

Abstract

Research reveals that the decision to withdraw life-sustaining medical treatment is commonly faced by surrogate decision makers of the critically ill. Factors noted to be considered by healthcare providers when addressing the decision to withdraw life-sustaining treatment include poor patient prognosis, poor patient quality of life should the patient survive, and the patient's previously expressed wishes regarding life sustaining treatment.

The purpose of this study was to determine the factors that are present in surrogates' decisions to withdraw life-sustaining mechanical ventilation from the critically ill adult. The target population was 31 surrogate decision-makers who had agreed to withdraw life-sustaining mechanical ventilation from a critically ill adult in a north central regional hospital 15 to 39 months prior to the issuing of the survey. Patients determined to be brain dead or did not die within IO days of the withdrawal of mechanical ventilation were excluded. The sample consisted of IO surrogates. Eight of the respondents were spouses of the patients and two were adult children of the patients.

Through the use of a questionnaire titled Factors Present in the Decision to Withdraw Mechanical Ventilation, including demographic data and one open-ended question, surrogates unanimously agreed that surrogates and physicians should collaborate to make the decision to withdraw life-sustaining treatment, and that they were confident they made the decision their loved one would have wanted them to make in that situation. Surrogates agreed with previous studies of surrogates and healthcare providers that the expressed wishes of the patient, potential poor quality of life, and poor prognosis were major factors in their decision to withdraw mechanical ventilation. Information provided by healthcare professionals was clear and consistent. There was little agreement that patient age, financial cost, or the physical appearance of the patient influenced the decision to withdraw mechanical ventilation. Surrogates did not feel pressured to withdraw mechanical ventilation, nor did their decision conflict with others involved in the case. Primarily due to the small number of respondents, chi-square analyses were not statistically significant.

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