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O-040 End-of-life Decision Making – Paediatric Intensivists’ And Nonintensivist Paediatricians’ Attitudes
  1. S Grosek1,
  2. M Orazem2,
  3. M Kanic3,
  4. G Vidmar4,
  5. U Groselj5
  1. 1Pediatric Surgery and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia
  2. 2Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  3. 3Department for Rhythmology, Heartcenter Leipzig, Leipzeg, Germany
  4. 4Department for Research, University Rehabilitation Institute of the Republic of Slovenia, Ljubljana, Slovenia
  5. 5Department of Paediatric Endocrinology Diabetes and Metabolic Diseases, University Children’s Hospital University Medical Center Ljubljana, Ljubljana, Slovenia

Abstract

Objective To describe the attitudes at the end-of-life decision (EOLD) making among Slovene paediatricians.

Design A cross-sectional survey using questionnaire and case scenario.

Setting Paediatric Health Care Institutions in Slovenia.

Participants Paediatric intensivists, specialists and residents in paediatrics.

Interventions None.

Main outcome measures Differences between attitudes regarding EOLD.

Results 323 participants of registered paediatricians in Slovenia 586 (55.1%) were included. The response rate was 46.7% (151 of 323 paediatricians) or 25.8% (151 of 586 of registered paediatricians). The decision to limit life-sustaining treatment at (LST) the end-of-life was ethically acceptable among Slovene paediatricians. The highest consent was found among residents 90.2%, followed by 83.3% of intensivists and 73.8% of specialists. Ethical differences between withholding and withdrawing were found in all three groups found, though intensivists agreed on this issue the least, in only 25.1%, while specialists and residents consented almost evenly, 40.0% and 40.7%, respectively. Answers on attitudes of EOLD did not show any statistical differences. 28.3% of specialists would follow do-not resuscitate order in comparison to 59.1% and 64.2% of intensivists and residents. The majority of participants answered that religious and cultural beliefs of paediatricians should not be considered in EOLD. In the presented case scenario intensivists would wait with the EOLD until the morning meeting and continue full treatment in contrast to specialists and residents.

Conclusions No major differences were found among paediatricians on attitudes about EOLD, while in case scenario intensivists were found to be more cautious in EOLD.

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