| Default options and neonatal resuscitation decisions. | |
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MedLine Citation:
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PMID: 23180252 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: To determine whether presenting delivery room management options as defaults influences decisions to resuscitate extremely premature infants. MATERIALS AND METHODS: Adult volunteers recruited from the world wide web were randomised to receive either resuscitation or comfort care as the delivery room management default option for a hypothetical delivery of a 23-week gestation infant. Participants were required to check a box to opt out of the default. The primary outcome measure was the proportion of respondents electing resuscitation. Data were analysed using χ(2) tests and multivariate logistic regression. RESULTS: Participants who were told the delivery room management default option was resuscitation were more likely to opt for resuscitation (OR 6.54 95% CI 3.85 to 11.11, p<0.001). This effect persisted on multivariate regression analysis (OR 7.00, 95% CI 3.97 to 12.36, p<0.001). Female gender, being married or in a committed relationship, being highly religious, experiences with prematurity, and favouring sanctity of life were significantly associated with decisions to resuscitate. DISCUSSION: Presenting delivery room options for extremely premature infants as defaults exert a significant effect on decision makers. The information structure of the choice task may act as a subtle form of manipulation. Further, this effect may operate in ways that a decision maker is not aware of and this raises questions of patient autonomy. CONCLUSION: Presenting delivery room options for extremely premature infants as defaults may compromise autonomous decision-making. |
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Authors:
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Marlyse Frieda Haward; Ryan O Murphy; John M Lorenz |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of medical ethics Volume: 38 ISSN: 1473-4257 ISO Abbreviation: J Med Ethics Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-11-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7513619 Medline TA: J Med Ethics Country: England |
Other Details:
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Languages: eng Pagination: 713-8 Citation Subset: E; IM |
Affiliation:
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Neonatal Office, The Valley Hospital, 223 North Van Dien Avenue, Ridgewood, NJ 07450, USA. mhaward@aol.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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