TY - JOUR
T1 - Dignity in end-of-life care
T2 - Results of a national survey of U.S. physicians
AU - Antiel, Ryan M.
AU - Curlin, Farr A.
AU - James, Katherine M.
AU - Sulmasy, Daniel P.
AU - Tilburt, Jon C.
N1 - Funding Information:
This publication was made possible by the Mayo Clinic Department of Medicine funding to Dr. Tilburt and from Grant Number 1 KL2 RR024151 from the National Center for Research Resources (NCRR) , a component of the National Institutes of Health (NIH), and the NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the NCRR or NIH. Information on the NCRR is available at http://www.ncrr.nih.gov/ . Information on Reengineering the Clinical Research Enterprise can be obtained from http://nihroadmap.nih.gov . Mr. Antiel was supported by predoctoral fellowship support from the Mayo Clinic Program in Professionalism and Ethics. The investigators received valuable support in the design and implementation of the study from the Mayo Clinic Survey Research Center.
PY - 2012/9
Y1 - 2012/9
N2 - Context: Debates persist about the relevance of "dignity" as an ethical concept in U.S. health care, especially in end-of-life care. Objectives: To describe the attitudes and beliefs regarding the usefulness and meaning of the concept of dignity and to examine judgments about a clinical scenario in which dignity might be relevant. Methods: Two thousand practicing U.S. physicians, from all specialties, were mailed a survey. Main measures included physicians' judgments about an end-of-life clinical scenario (criterion variable), attitudes about the concept of dignity (predictors), and their religious characteristics (predictors). Results: Responses were received from 1032 eligible physicians (54%). Nine (90%) of 10 physicians reported that dignity was relevant to their practice. After controlling for age, gender, region, and specialty, physicians who judged that the case patient had either some dignity or full dignity, and who agreed that dignity is given by a creator, were all positively associated with believing that the patient's life was worth living (odds ratio [OR] 10.2, 95% confidence interval [CI] 5.8-17.8, OR 20.5, 95% CI 11.4-36.8, OR 4.7, 95% CI 3.1-7.0, respectively). Respondents who strongly agreed that "all living humans have the same amount of dignity" were also more likely to believe that the patient's life was worth living (OR 1.8, 95% CI 1.2-2.7). Religious characteristics also were associated with believing that the case patient's life was worth living (OR 4.1, 95% CI 2.4-7.2, OR 3.2, 95% CI 1.6-6.3, OR 9.2, 95% CI 4.3-19.5, respectively). Conclusion: U.S. physicians view the concept of dignity as useful. Those views are associated with their judgments about common end-of-life scenarios in which dignity concepts may be relevant.
AB - Context: Debates persist about the relevance of "dignity" as an ethical concept in U.S. health care, especially in end-of-life care. Objectives: To describe the attitudes and beliefs regarding the usefulness and meaning of the concept of dignity and to examine judgments about a clinical scenario in which dignity might be relevant. Methods: Two thousand practicing U.S. physicians, from all specialties, were mailed a survey. Main measures included physicians' judgments about an end-of-life clinical scenario (criterion variable), attitudes about the concept of dignity (predictors), and their religious characteristics (predictors). Results: Responses were received from 1032 eligible physicians (54%). Nine (90%) of 10 physicians reported that dignity was relevant to their practice. After controlling for age, gender, region, and specialty, physicians who judged that the case patient had either some dignity or full dignity, and who agreed that dignity is given by a creator, were all positively associated with believing that the patient's life was worth living (odds ratio [OR] 10.2, 95% confidence interval [CI] 5.8-17.8, OR 20.5, 95% CI 11.4-36.8, OR 4.7, 95% CI 3.1-7.0, respectively). Respondents who strongly agreed that "all living humans have the same amount of dignity" were also more likely to believe that the patient's life was worth living (OR 1.8, 95% CI 1.2-2.7). Religious characteristics also were associated with believing that the case patient's life was worth living (OR 4.1, 95% CI 2.4-7.2, OR 3.2, 95% CI 1.6-6.3, OR 9.2, 95% CI 4.3-19.5, respectively). Conclusion: U.S. physicians view the concept of dignity as useful. Those views are associated with their judgments about common end-of-life scenarios in which dignity concepts may be relevant.
KW - Human dignity
KW - end-of-life care
KW - physician religiosity
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U2 - 10.1016/j.jpainsymman.2011.09.020
DO - 10.1016/j.jpainsymman.2011.09.020
M3 - Article
C2 - 22762966
AN - SCOPUS:84865689544
SN - 0885-3924
VL - 44
SP - 331
EP - 339
JO - Journal of pain and symptom management
JF - Journal of pain and symptom management
IS - 3
ER -