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논문 기본 정보

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학술저널
저자정보
Yoo Shin Hye (Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Korea.) Lee Jung (Center for Integrative Care Hub, Seoul National University Hospital, Seoul, Korea.) Song In Gyu (Department of Pediatrics, Yonsei University Severance Children’s Hospital, Seoul, Korea.) Jeon So Yeon (Department of Psychiatry, Chungnam National University Hospital, Daejeon, Korea.Department of Psychiatry, Chungnam National University College of Medicine, Daejeon, Korea.) Kim Min Sun (Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Korea.Center for Integrative Care Hub, Seoul National University Hospital, Seoul, Korea.Department) Park Hye Yoon (Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Korea.Department of Psychiatry, Seoul National University Hospital, Seoul National University Colle)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.39 No.35
발행연도
2024.9
수록면
1 - 14 (14page)
DOI
10.3346/jkms.2024.39.e242

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초록· 키워드

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Background: The vegetative state (VS) after severe acute brain injury (SABI) is associated with significant prognostic uncertainty and poor long-term functional outcomes. However, it is generally distinguished from imminent death and is exempt from the Life-Sustaining Treatment (LST) Decisions Act in Korea. Here, we aimed to examine the perspectives of the general population (GP) and clinicians regarding decisions on mechanical ventilator withdrawal in patients in a VS after SABI. Methods: A cross-sectional survey was undertaken, utilizing a self-reported online questionnaire based on a case vignette. Nationally selected by quota sampling, the GP comprised 500 individuals aged 20 to 69 years. There were 200 doctors from a tertiary university hospital in the clinician sample. Participants were asked what they thought about mechanical ventilator withdrawal in patients in VS 2 months and 3 years after SABI. Results: Two months after SABI in the case, 79% of the GP and 83.5% of clinicians had positive attitudes toward mechanical ventilator withdrawal. In the GP, attitudes were associated with spirituality, household income, religion, the number of household members. On the other hand, clinicians’ attitudes were related to their experience of completing advance directives (AD) and making decisions about LST. In this case, 3 years after SABI, 92% of the GP and 94% of clinicians were more accepting of ventilator withdrawal compared to previous responses, based on the assumption that the patient had written AD. However, it appeared that the proportion of positive responses to ventilator withdrawal decreased when the patients had only verbal expressions (82% of the GP; 75.5% of clinicians) or had not previously expressed an opinion regarding LST (58% of the GP; 39.5% of clinicians). Conclusion: More than three quarters of both the GP and clinicians had positive opinions regarding ventilator withdrawal in patients in a VS after SABI, which was reinforced with time and the presence of AD. Legislative adjustments are needed to ensure that previous wishes for those patients are more respected and reflected in treatment decisions.
#Surveys and Questionnaires #Vegetative State #Brain Injuries #Mechanical Ventilator #Decision Making #Withdrawing Treatments #General Population #Clinicians

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