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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neurocritical and Neurohospitalist Care
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1358747
This article is part of the Research Topic Clinical imaging, neurophysiological, neuropathology and neuroethics studies on disorders of consciousness, coma mechanisms, and theories of consciousness: a unifying attempt View all articles

Perspectives of healthcare providers on withdrawal of life-sustaining treatment and advanced directives for unresponsive wakefulness syndrome in China

Provisionally accepted
Meiqi Li Meiqi Li *Siyu Dai Siyu Dai Le Wang Le Wang Haibo Di Haibo Di *
  • Hangzhou Normal University, Hangzhou, China

The final, formatted version of the article will be published soon.

    Objectives We performed the current research to describe healthcare providers' perspectives towards withdrawal of life-sustaining treatment (WLST) and advanced directive (AD) of patients with unresponsive wakefulness syndrome (UWS) and to identify influencing factors of their perspectives.Methods Healthcare providers were recruited during a professional conference on disorders of consciousness (DoC). Participants completed self-administered questionnaires which included demographics, personal perspectives regarding WLST and the perception of ADs.Results A total of 230 Chinese healthcare providers (female: 69.7%) were included. Only a small proportion reported positive attitudes towards withdrawing artificial nutrition and hydration (35.2%), antibiotics (30.9%), and do-not-resuscitation orders (23.5%) in UWS patients. As for predictors' identification, religion was significantly associated with the positive attitude towards DNR order (P=0.004). Moreover, although 47.4% of the participants had never heard of ADs before of conference, almost all of them would consider ADs (95.7%) thereafter, especially for non-neurologists (P=0.033).The propensity to WLST for UWS in China is low and perspective on WLST is significantly associated with individual characteristics. The attitudes of healthcare providers toward integrating ADs in the decisional process are positive. Future research regarding ADs and their predictors should be carried out to improve the quality of end-of-life care of UWS in China.

    Keywords: Advanced directives, disorders of consciousness, unresponsive wakefulness syndrome, withdrawal of life-sustaining treatment, Ethics

    Received: 20 Dec 2023; Accepted: 28 Jun 2024.

    Copyright: © 2024 Li, Dai, Wang and Di. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Meiqi Li, Hangzhou Normal University, Hangzhou, China
    Haibo Di, Hangzhou Normal University, Hangzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.