Table 4.
Appraisal of ethical challenges in the decision-making process for VS patients
| |
Median (1
st
, 3
rd
quartile) on NRS (0-10) |
|
|||||
|---|---|---|---|---|---|---|---|
| All groups* (n = 332) | Rank order | Canadian group* (n = 200) | Rank order | German group* (n = 132) | Rank order | p value | |
| Determining patient’s wishes (n = 320) |
7 (5,9) |
1 |
7 (4.5,8) |
2 |
8 (7,10) |
1 |
p < 0.001 |
| Accompanying family members in decisions (n = 322) |
7 (5,8) |
2 |
6 (3,8) |
4 |
7 (6,9) |
3 |
p < 0.001 |
| Finding long-term care (n = 314) |
7 (4,9) |
3 |
8 (4,9) |
1 |
6 (4,8) |
6 |
p = 0.007 |
| Making prognosis and predicting recovery (n = 323) |
7 (4,9) |
3 |
7 (3,8) |
3 |
8 (7,10) |
1 |
p < 0.001 |
| Evaluating resource allocation (n = 318) |
7 (3,9) |
4 |
6 (3,8) |
4 |
7 (4,9) |
4 |
p = 0.010 |
| Deciding for patient in absence of surrogate (n = 321) |
7 (4,9) |
4 |
5 (2,7) |
6 |
8 (7,10) |
1 |
p < 0.001 |
| Assessing medical futility (n = 319) |
6 (3,8) |
5 |
4 (2,7) |
7 |
7 (5,8) |
5 |
p < 0.001 |
| Making correct diagnosis (n = 325) |
6 (2,8) |
6 |
5 (2,8) |
5 |
7 (4,9) |
4 |
p < 0.001 |
| Discontinuing LST (n = 323) |
6 (2,8) |
6 |
4 (2,7) |
7 |
8 (5,10) |
2 |
p < 0.001 |
| Accompanying clients through staff rotations (n = 313) |
5 (3,7) |
7 |
5 (2,7) |
6 |
6 (3.5,8) |
7 |
p = 0.002 |
| Applying a decision made by surrogate (n = 318) |
5 (3,7) |
7 |
4 (2,6) |
8 |
7 (5,8) |
5 |
p < 0.001 |
| Reaching an agreement as a team (n = 320) |
4 (2,6) |
8 |
3 (2,5) |
10 |
5 (3,7) |
9 |
p < 0.001 |
| Multidisciplinary discussions for decisions (n = 321) | 3 (1,5) | 9 | 2 (1,4) | 9 | 5 (3,7) | 8 | p < 0.001 |
*Those who assigned the correct diagnosis to the patient in the case; Mann-Whitney-U test; average rank order according to Median, 1st and 3rd quartile on NRS (0-10).