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dc.contributor.authorWhite, Ben P
dc.contributor.authorWillmott, Lindy
dc.contributor.authorCartwright, Colleen
dc.contributor.authorParker, Malcolm
dc.contributor.authorWilliams, Gail
dc.contributor.authorDavis, Juliet
dc.date.accessioned2020-10-19T02:47:10Z
dc.date.available2020-10-19T02:47:10Z
dc.date.issued2017
dc.identifier.issn1472-684Xen_US
dc.identifier.doi10.1186/s12904-017-0249-1en_US
dc.identifier.urihttp://hdl.handle.net/10072/398456
dc.description.abstractBackground: Law purports to regulate end-of-life care but its role in decision-making by doctors is not clear. This paper, which is part of a three-year study into the role of law in medical practice at the end of life, investigates whether law affects doctors' decision-making. In particular, it considers whether the fact that the law differs across Australia's three largest states - New South Wales (NSW), Victoria and Queensland - leads to doctors making different decisions about withholding and withdrawing life-sustaining treatment from adults who lack capacity. Methods: A cross-sectional postal survey of the seven specialties most likely to be involved in end-of-life care in the acute setting was conducted between 18 July 2012 and 31 January 2013. The sample comprised all medical specialists in emergency medicine, geriatric medicine, intensive care, medical oncology, palliative medicine, renal medicine and respiratory medicine on the AMPCo Direct database in those three Australian states. The survey measured medical specialists' level of legal compliance, and reasons for their decisions, concerning the withholding or withdrawal of life-sustaining treatment. Multivariable logistic regression was used to examine predictors of legal compliance. Linear regression was used to examine associations between the decision about life-sustaining treatment and the relevance of factors involved in making these decisions, as well as state differences in these associations. Results: Response rate was 32% (867/2702). A majority of respondents in each state said that they would provide treatment in a hypothetical scenario, despite an advance directive refusing it: 72% in NSW and Queensland; 63% in Victoria. After applying differences in state law, 72% of Queensland doctors answered in accordance with local law, compared with 37% in Victoria and 28% in NSW (p < 0.001). Doctors reported broadly the same decision-making approach despite differences in local law. Conclusions: Law appears to play a limited role in medical decision-making at the end of life with doctors prioritising patient-related clinical and ethical considerations. Different legal frameworks in the three states examined did not lead to different decisions about providing treatment. More education is needed about law and its role in this area, particularly where law is inconsistent with traditional practice.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.language.isoeng
dc.publisherBMCen_US
dc.relation.ispartofpagefrom63en_US
dc.relation.ispartofissue1en_US
dc.relation.ispartofjournalBMC Palliative Careen_US
dc.relation.ispartofvolume16en_US
dc.subject.fieldofresearchNursingen_US
dc.subject.fieldofresearchPublic Health and Health Servicesen_US
dc.subject.fieldofresearchcode1110en_US
dc.subject.fieldofresearchcode1117en_US
dc.subject.keywordsScience & Technologyen_US
dc.subject.keywordsLife Sciences & Biomedicineen_US
dc.subject.keywordsHealth Care Sciences & Servicesen_US
dc.subject.keywordsHealth Policy & Servicesen_US
dc.subject.keywordsEnd-of-life decision-makingen_US
dc.titleComparing doctors' legal compliance across three Australian states for decisions whether to withhold or withdraw life-sustaining medical treatment: does different law lead to different decisions?en_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dcterms.bibliographicCitationWhite, BP; Willmott, L; Cartwright, C; Parker, M; Williams, G; Davis, J, Comparing doctors' legal compliance across three Australian states for decisions whether to withhold or withdraw life-sustaining medical treatment: does different law lead to different decisions?, BMC Palliative Care, 2017, 16 (1), pp. 63en_US
dcterms.dateAccepted2017-11-16
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/en_US
dc.date.updated2020-10-19T01:55:30Z
dc.description.versionVersion of Record (VoR)en_US
gro.rights.copyright© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stateden_US
gro.hasfulltextFull Text
gro.griffith.authorDavis, Juliet E.


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