Physicians' Attitudes Toward DNR of Terminally Ill Cancer Patients in Taiwan

Co-Shi Chantal Chao

CPR (Cardiopulmonary Re sus ci ta tion) ； DNR (Do Not Re sus ci tate) ； ter mi nally ill can cer pat ients ； ad vance directives ； natural death

The Journal of Nursing Research

10卷3期（2002 / 09 / 01）

161 - 167

英文

The purpose of this study was to survey physicians’ attitudes toward DNR of terminally ill cancer patients in Taiwan. A total of7626 structured questionnaires were sent by mail to physicians who were members of the Taiwan Society of lnternal Medicine and the Surgical Association of Tai w an, and 1328 valid responses were received. The response rate was l7.6°o. The in strument, a structured questionnaire, was com posed of one scenario and six questions. A majority (77.6%) of the physicians under investigation would tell a terminally ill cancer patient or his family about the possibility of DNR and ask them to consider signing a con sent form. Over one half of the physicians (58.4%) did not know whether the Mcdical Law in Taiwan permits natural death, and 96.1% of the subjects felt they would need legal protection for agreeing patient’s autonomy to decide DNR. Unfortunately, 41.2% of the respondent admitted that they did not have aformal Informed Con sent Form that could be used for DNR. Even of those who had such a form, only 27.4% had clear guide lines given by their institutions. Among 623 physicians whose institutions had an for mal Informed Con sent Form for DNR, 63.7% agreed that it was rcasonablyused. Surprisingly, 67.9% of the physicians had used Slow Codes. The findings of this study served as a solid base. The investigator and other colleagues used it to convince leg is lators to pass a Natural Death Actin Tai ‘wan. Since some legislators disliked the term “death” and the main pro motes were peoplcengaged in hospice palliative care, the new law entitled “Hospice Palliative Act” was passed on May 23, 2000. The DNR order finally gained its legal base for medical practice. The limitation of this study was the low response rate. How ever, since the subjects, physicians, had a busy workload, this was still anaccept able response rate.

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