Korean J Fam Pract. 2017; 7(4): 520-526  https://doi.org/10.21215/kjfp.2017.7.4.520
The Influence of Roles and Extent of Information on Decision Making for Life Sustaining Treatment
Ahram Hong, Jung-Hyun Kim*, Hyeon-Guk Shin, Hyun-Woo Kwon, Jae-Hyun Youn, Young-Il Kim, Yun-Jae Han
Department of Family Medicine, Hana General Hopital, Cheongju, Korea
Jung-Hyun Kim
Tel: +82-43-230-6230, Fax: +82-43-230-6231
E-mail: astrobass@hanmail.net
Received: August 11, 2016; Revised: September 26, 2016; Accepted: October 4, 2016; Published online: August 20, 2017.
© Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: The need for the consideration of decisions about terminal care has emerged with the development of medical technology. In this study, we used simulations to examine the differences in the decisions made with reference to different roles and extent of information, to provide basic material to establish guidelines on decision making in terminal situations.
Methods: Subjects were adult college students. We calibrated and compensated the decision making results of people with experience with long-time hospitalization to correct for the possible bias from preconceived notions. Decision making was assessed using responses to a self-produced, selfreported questionnaire. The roles and information differed between the groups. The general characteristics of the respondents were analyzed using the one-way ANOVA and chi-square tests. The Pearson’s chi square test was used to analyze the decisions, and a logistic regression was used to calculate the odd ratios of selected options.
Results: In total, 218 people participated in this study. In the two patients groups with standard and extended information, the selection rates of cardiopulmonary resuscitation were 60.0% and 90.6% (P<0.001), respectively, and those of respirator were 54.5% and 75.5% (P=0.023), respectively . The selection rates did not vary significantly among the surrogate groups. In the standard information groups of patients and surrogates, the selection rates of cardiopulmonary resuscitation were 60.0% and 96.3% (P<0.001), respectively, those of respirator were 54.5% and 90.7% (P<0.001), respectively, and those of hemodialysis were 60.0% and 81.5% (P=0.024), respectively. The selection rates did not vary significantly among the extended information groups.
Conclusion: In the simulation, subjects chose life sustaining treatment more actively when they were surrogates than when they were patients, and when they were provided extended information.
Keywords: Terminal Care; Decision Making; Representatives; Personal Autonomy
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