@article {Monteirorespcare.02695, author = {Filipe Monteiro}, title = {Family reliance on physicians{\textquoteright} decisions in life-sustaining treatments in acute-on-chronic respiratory diseases in a respiratory intensive care unit: A single center study}, elocation-id = {respcare.02695}, year = {2013}, doi = {10.4187/respcare.02695}, publisher = {Respiratory Care}, abstract = {Introduction: In intensive care units, many patients are unable to participate in decision making regarding life-sustaining treatments. This study aimed to evaluate the opinion of family members about family and physician participation in lifesustaining treatment decisions and to examine which factors can influence the decision. Methods: This is a prospective exploratory observational study using convenience sampling. Inquiry interviews were conducted over a 3-year period with 126 family members (out of 303 potential participants) of patients with acute-on-chronic respiratory failure, who had been admitted to the respiratory intensive care unit (RICU) and were dependent on invasive or noninvasive ventilation (without airways intubation). Patients of <=18 years, those with a stay length of less than 3 days, and oncologic patients were excluded. Results: A majority of the participant family members, 123/126 (97.6\%) had an opinion about their involvement in decision making about life-sustaining treatments. Physician choice preferred by 54/123 (43.90\%), 55/123 (44.72\%) wished to share the decision with the physician, and 14/123 (11.38\%) decided for a family option. All the patients were incompetent at the time of inquiry. Autonomy prior to admission to the RICU influenced the decision. Conclusions: A majority of families rely on physicians to help in the decision-making process of life-sustaining treatments in acute-on-chronic respiratory diseases. From the family point of view, the principle of autonomy can be exercised by surrogating the decision making process to the physician. The sociological and cultural characteristics of each country deserve special attention in these kinds of studies.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/early/2013/08/20/respcare.02695}, eprint = {https://rc.rcjournal.com/content/early/2013/08/20/respcare.02695.full.pdf}, journal = {Respiratory Care} }