0
Original Research: Palliative Care and End of Life/Ethics |

Formal Academic Training on Ethics May Address Junior Physicians’ Needs

Michael Darmon, MD, PhD; Guillaume Ducos, MD; Isaline Coquet, MD; Matthieu Resche-Rigon, MD, PhD; Frederic Pochard, MD, PhD; Marie Paries, MD; Nancy Kentish-Barnes, PhD; Marine Chaize, MS; Benoit Schlemmer, MD; Elie Azoulay, MD, PhD
Author and Funding Information

Drs Ducos and Coquet contributed equally to this work.

FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.

aMedical-Surgical Intensive Care Unit, Saint-Etienne University Hospital, Saint-Etienne, France

bMedical Intensive Care Unit and FAMIREA Study Group, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France

cBiostatistic Department, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France

dFaculté de Médecine, Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France

CORRESPONDENCE TO: Michael Darmon, MD, PhD, Medical-Surgical ICU, Saint-Etienne University Hospital, Ave Albert Raymond, 42270 Saint-Priest-en-Jarez, France


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(1):180-187. doi:10.1016/j.chest.2016.02.651
Text Size: A A A
Published online

Background  Surveys have highlighted perceived deficiencies among ICU residents in end-of-life care, symptom control, and confidence in dealing with dying patients. Lack of formal training may contribute to the failure to meet the needs of dying patients and their families. The objective of this study was to evaluate junior intensivists’ perceptions of triage and of the quality of the dying process before and after formal academic training.

Methods  Formal training on ethics was implemented as a part of resident training between 2007 and 2012. A cross-sectional survey was performed before (2007) and after (2012) this implementation. This study included 430 junior intensivists who were interviewed during these periods.

Results  More responders attended a dedicated training course on ethics and palliative care during 2012 (38.5%) than during 2007 (17.4%; P < .0001). During 2012, respondents reported less discomfort and fewer uncertainties regarding decisions about limiting life-sustaining treatment (17.7% vs 39.1% in 2007; P < .0001) or the triage process (48.5% vs 69.4% in 2007; P < .0001). Factors independently associated with positive perceptions of the dying process were physician’s age (OR, 1.19 per year; 95% CI, 1.09-1.25) and male sex (OR, 1.61; 95% CI, 1.05-2.47). Conversely, anxiety about family members’ reactions (OR, 0.58; 95% CI, 0.0.37-0.87) and lack of training (OR, 0.29; 95% CI, 0.17-0.50) were associated with negative perceptions of this process.

Conclusions  Formal training dedicated to ethics and palliative care was associated with a more comfortable perception of the dying process. This training may decrease the uncertainty and discomfort of junior intensivists in these situations.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543