To assess the preference of critically ill patients family members in Islamic country on who should decide to hold therapy if needed.
A prospective survey was carried out of close relatives of all consecutive terminally ill patients admitted to ICU for more than 24 hours. One representative in each family was approached with a four question survey. The questions are as below.1) If your loved one is dying, would you sign consent to hold treatment considered by the physician to be of no meaningful benefit? 2) Do you feel comfortable to sign consent to withhold artificial measure of resuscitation in case your relative is terminally ill?3) Would you feel guilty if you are signing the consent to hold artificial means for your dying relative?4) What do you think is the correct approach?a) The relative should sign consent before holding therapyb) The decision should be solely made by physicianc) The physician should decide after informing the familyd) Joint decision of two physicians and inform the family?.
A total of 220 family ,members participated in the questionnaire, 165 (75%) did not agree to sign consent and 212 (96.4%) mentioned that personal guilt is a major issue. Of the 55 (25%) who agreed to consent, only 5 (2.3%) actually recommended it and 47 (85.5%) felt guilty about signing it. 215 (97.7%) believe that the decision to without treatment should be made by the physician, 207/220 (94.1%) request to be informed and 8 (3.6%) prefer the physician to decide without informing them. 79 (35.9%) recommend a joint decision by two physicians.
This is first study involving opinion of critically-ill patient relatives on decision to withdraw therapy in the Islamic community. The relatives of critically ill patient do not want to be main decision maker. They favor physicians to take this decision preferably after informing them.
These findings should be considered in formulating a policy on foregoing medical treatment in our community.
Said Abuhasna, No Financial Disclosure Information; No Product/Research Disclosure Information