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Internal Medicine Journal
Article . 2015 . Peer-reviewed
License: Wiley Online Library User Agreement
Data sources: Crossref
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Medical education and law: withholding/withdrawing treatment from adults without capacity

Authors: Parker, M; Willmott, L; White, B; Williams, G; Cartwright, Colleen M;

Medical education and law: withholding/withdrawing treatment from adults without capacity

Abstract

AbstractBackgroundLaw is increasingly involved in clinical practice, particularly at the end of life, but undergraduate and postgraduate education in this area remains unsystematic. We hypothesised that attitudes to and knowledge of the law governing withholding/withdrawing life‐sustaining treatment from adults without capacity (the WWLST law) would vary and demonstrate deficiencies among medical specialists.AimsWe investigated perspectives, knowledge and training of medical specialists in the three largest (populations and medical workforces) Australian states, concerning the WWLST law.MethodsFollowing expert legal review, specialist focus groups, pre‐testing and piloting in each state, seven specialties involved with end‐of‐life care were surveyed, with a variety of statistical analyses applied to the responses.ResultsRespondents supported the need to know and follow the law. There were mixed views about its helpfulness in medical decision‐making. Over half the respondents conceded poor knowledge of the law; this was mirrored by critical gaps in knowledge that varied by specialty. There were relatively low but increasing rates of education from the undergraduate to continuing professional development (CPD) stages. Mean knowledge score did not vary significantly according to undergraduate or immediate postgraduate training, but CPD training, particularly if recent, resulted in greater knowledge. Case‐based workshops were the preferred CPD instruction method.ConclusionsTeaching of current and evolving law should be strengthened across all stages of medical education. This should improve understanding of the role of law, ameliorate ambivalence towards the law and contribute to more informed deliberation about end‐of‐life issues with patients and families.

Country
Australia
Keywords

Medical education, Adult, Male, Legal compliance, Adult guardianship law, medical, Education, terminal care, Cohort Studies, Withholding and withdrawing life-sustaining medical treatment, Medical, End of life decision-making, Health law, Physicians, Surveys and Questionnaires, Medicine and Health Sciences, Terminal care, Humans, medical law, withholding treatment, education, Terminal Care, Knowledge of law, 340, Education, Medical, Australia, decision-making, Medical law, Withholding Treatment, 2724 Internal Medicine, Female, Clinical Competence

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
13
Top 10%
Average
Average
Green