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Journal of Medical Ethics logoLink to Journal of Medical Ethics
. 2000 Aug;26(4):254–260. doi: 10.1136/jme.26.4.254

Are medical ethicists out of touch? Practitioner attitudes in the US and UK towards decisions at the end of life

D Dickenson 1
PMCID: PMC1733246  PMID: 10951920

Abstract

Objectives—To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effect

Design, subjects and setting–A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on "Death and Dying" was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on "Decisions near the End of Life".

Results–Practitioners accept the relevance of concepts widely disparaged by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/ withdrawing treatment. Within the UK nurses' group a "rationalist" axis of respondents who describe themselves as having "no religion" are closer to the bioethics consensus on withholding and withdrawing treatment.

Conclusions—Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners.

Key Words: Death and dying • withdrawal of care • refusal of treatment

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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