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End-of-life indecision.

More than a third of patients with chronic illnesses may ultimately change their minds about life saving emergency procedures. This suggests that doctors need to discuss these options with their patients more frequently.

A study in the Netherlands focused on 206 patients with chronic obstructive pulmonary disease, chronic heart failure, or chronic renal failure who were in stable condition at the start of the study. The patients were monitored every four months for a year to assess their preferences for resuscitation and mechanical ventilation in the event of cardiac arrest.

At the end of the year, 38% had altered their initial preference--and the changes of mind went both ways, for resuscitation and against, according to lead researcher Daisy Janssen of the Centre of Expertise for Chronic Organ Failure.

Factors contributing to the revised preferences included changes in health status, mobility, marital status, and symptoms of anxiety and depression. Janssen calls for reevaluation of health care planning protocols, better communication between doctors and patients, and improved training for doctors and nurses in end-of-life care.

Source: CIRO+ Centre of Expertise for Chronic Organ Failure, The study was presented at the European Respiratory Society Annual Congress in Amsterdam (September 26, 2011). Details: European Lung Foundation,

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Title Annotation:Values / HUMANITY
Publication:The Futurist
Article Type:Brief article
Geographic Code:4EUNE
Date:Mar 1, 2012
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