Table 2.
Number of Students’ “Yes” Responses to Each Question
| Non-medical students (NMS) ( = 90) | Medical students (MS) year 1 ( = 85) | Medical students year 2 ( = 101) | Medical students year 3 ( = 59) | Medical students year 5 ( = 67) | All medical students ( = 312) | χ2 for differences between MS & NMS | Χ2 for trend amongst MS |
|---|---|---|---|---|---|---|---|
| INFORMATION DELIVERY | |||||||
| Medical information given to patients and their family should include everything | |||||||
| 54/89 (61) | 27/81 (33) | 36/98 (37) | 16/59 (27) | 11/66 (17) | 90/304 (30) | < 0.001 | = 0.01 |
| Medical information given to patients and their family should be limited | |||||||
| 35/89(39) | 54/81(67) | 62/98(63) | 43/59(73) | 55/66(83) | 214/304(70) | < 0.001 | = 0.01 |
| Information given in the event of an iatrogenic incident should include everything | |||||||
| 64/90 (71) | 48/85 (56) | 57/101 (56) | 25/59 (42) | 25/67 (37) | 155/312(50) | < 0.001 | = 0.006 |
| Information given in the event of an iatrogenic incident should be limited or no information provided | |||||||
| 26/90 (29) | 37/85 (44) | 44/101 (44) | 34/59 (58) | 42/67 (63) | 157/312(50) | < 0.001 | = 0.006 |
| INFORMED CONSENT | |||||||
| If a sufficiently capable person refuses surgery that is necessary and life-threatening doctors should: | |||||||
| Try and convince the patient but if patient refuses, accept the patient’s decision | |||||||
| 67/90 (74) | 80/85 (94) | 92/101 (91) | 58/59 (98) | 65/67 (97) | 295/312(95) | < 0.001 | = 0.18 |
| Treat the patient according to what the doctor thinks is right | |||||||
| 18/90 (20) | 3/85 (4) | 7/101 (7) | 0/59 (0) | 2/67 (3) | 12/312 (4) | < 0.001 | = 0.40 |
| Inform the patient that the doctor is no longer able to look after them | |||||||
| 5/90 (6) | 2/85 (2) | 2/101 (2) | 1/59 (2) | 0/67 (0) | 5/312 (2) | = 0.05 | = 0.26 |
| If a sufficiently capable person refuses surgery that is necessary but NOT life-threatening doctors should: | |||||||
| Try and convince the patient but if patient refuses, accept the patient’s decision | |||||||
| 78/90 (87) | 83/84 (99) | 97/100 (97) | 59/59 (100) | 66/67 (99) | 305/310(98) | = 0.64 | = 0.76 |
| Treat the patient according to what the doctor thinks is right | |||||||
| 5/90 (6) | 1/84 (1) | 1/100 (1) | 0/59 (0) | 0/67 (0) | 2/310 (1) | = 0.008 | = 0.27 |
| Inform the patient that the doctor is no longer able to look after them | |||||||
| 7/90 (8) | 0/84 (0) | 2/100 (2) | 0/59 (0) | 1/67 (1) | 3/310 (1) | = 0.002 | = 0.62 |
| CARDIOPULMONARY RESUSCITATION (CPR) | |||||||
| CPR must always be provided | |||||||
| 76/90 (84) | 67/84 (80) | 74/101 (73) | 35/59 (59) | 18/67 (27) | 194/311(62) | < 0.001 | < 0.001 |
| Discussion when withholding CPR: | |||||||
| In mentally capable patients, withholding CPR should be discussed with patients | |||||||
| 11/14 (79) | 16/16 (100) | 25/27 (93) | 24/24 (100) | 46/47 (98) | 111/114(97) | = 0.02 | = 0.72 |
| In mentally capable patients, withholding CPR should be discussed with the family | |||||||
| 8/14 (57) | 10/17 (59) | 12/27 (44) | 20/24 (83) | 38/47 (81) | 80/115 (70) | = 0.35 | = 0.004 |
| In mentally incapable patients, withholding CPR should be discussed with the family | |||||||
| 10/14 (71) | 14/15 (93) | 25/27 (93) | 23/24 (96) | 44/47 (94) | 106/113(94) | = 0.02 | = 0.89 |
| WITHHOLDING AND DISCONTINUING LIFE-SUPPORT | |||||||
| Withholding life-support therapy is acceptable | |||||||
| 41/90 (46) | 44/83 (53) | 41/101 (41) | 35/58 (60) | 54/66 (82) | 174/308(56) | = 0.07 | < 0.001 |
| Discontinuing life-support therapy is acceptable | |||||||
| 20/90 (22) | 18/83 (22) | 21/98 (21) | 19/58 (33) | 27/66 (41) | 85/305 (27) | = 0.29 | = 0.003 |
| Euthanasia is acceptable | |||||||
| 57/89 (64) | 42/84 (50) | 51/97 (53) | 25/58 (43) | 15/66 (23) | 133/305(44) | < 0.001 | < 0.001 |
| For patients who have no real chance of recovering good quality of life, if the family insists on maximal medical therapy: | |||||||
| Doctors should continue maximal medical therapy including CPR | |||||||
| 55/86 (64) | 39/74 (53) | 55/95 (58) | 32/59 (54) | 13/61 (21) | 139/289(48) | = 0.01 | < 0.001 |
| Doctors should continue maximal medical therapy excluding CPR | |||||||
| 5/86 (6) | 2/74 (3) | 3/95 (3) | 2/59 (3) | 5/61 (8) | 12/289 (4) | = 0.56 | = 0.13 |
| Doctors should continue present care but withhold sophisticated treatments | |||||||
| 18/86 (21) | 18/74 (24) | 16/95 (17) | 18/59 (31) | 35/61 (57) | 87/289 (30) | = 0.10 | < 0.001 |
| Doctors should continue present care but withhold additional treatments | |||||||
| 8/86 (9) | 7/74 (9) | 11/95 (12) | 2/59 (3) | 2/61 (3) | 22/289 (8) | = 0.61 | = 0.06 |
| Other responses | |||||||
| 5/86 (6) | 8/74 (11) | 10/95 (11) | 5/59 (8) | 6/61 (10) | 29/289 (10) | = 0.29 | = 0.75 |
| KEY PARTICIPANTS IN DECISION-MAKING | |||||||
| In conscious and capable patients, the decision regarding limitation of life support therapy should involve: | |||||||
| Patients | |||||||
| 86/89 (97) | 82/84 (98) | 97/97 (100) | 59/59 (100) | 66/67 (99) | 304/307(99) | = 0.13 | = 0.58 |
| Families | |||||||
| 69/87 (79) | 55/76 (72) | 62/88 (70) | 38/59 (64) | 48/64 (75) | 203/287(71) | = 0.13 | = 0.95 |
| Doctors | |||||||
| 70/87 (80) | 69/81 (85) | 86/94 (91) | 51/59 (86) | 59/66 (89) | 265/300(88) | = 0.06 | = 0.64 |
| Nurses | |||||||
| 28/80 (35) | 23/70 (33) | 36/82 (44) | 18/59 (31) | 27/59 (46) | 104/270(39) | = 0.33 | = 0.37 |
| In unconscious and incapable patients, the decision regarding limitation of life support therapy should involve: | |||||||
| Families | |||||||
| 80/88 (91) | 78/84 (93) | 95/99 (96) | 57/59 (97) | 66/66 (100) | 296/308(96) | = 0.05 | = 0.03 |
| Doctors | |||||||
| 75/87 (86) | 75/83 (90) | 95/98 (97) | 57/59 (97) | 65/67 (97) | 292/307(95) | = 0.004 | = 0.08 |
| Nurses | |||||||
| 30/82 (37) | 33/69 (48) | 44/86 (51) | 27/59 (46) | 32/58 (55) | 136/272(50) | = 0.03 | = 0.58 |
| INTENSIVE CARE UNIT ADMISSION | |||||||
| Admit patients with no hope of survival for more than a few weeks | |||||||
| 52/88 (59) | 60/81 (74) | 53/99 (54) | 29/59 (49) | 13/66 (20) | 155/305(51) | = 0.17 | < 0.001 |
| Admit patients who may live for several years but whose quality of life is very poor according to the doctor’s opinion | |||||||
| 59/89 (66) | 72/83 (87) | 80/98 (82) | 50/59 (85) | 47/66 (71) | 249/306(81) | = 0.003 | = 0.03 |
| Admit patients who may live for several years but whose quality of life is very poor according to the patient’s opinion | |||||||
| 55/88 (63) | 65/83 (78) | 71/97 (73) | 42/59 (71) | 44/66 (67) | 222/305(73) | = 0.06 | = 0.11 |
| Admit patients with limited chances of survival | |||||||
| 69/89 (78) | 60/81 (74) | 82/97 (85) | 42/59 (71) | 26/65 (40) | 210/302(70) | = 0.14 | < 0.001 |
Data shown as number of “yes” responses over total possible responses by category (% “yes” responses)