%0 Journal Article
%T Life
%A Jose Filipe da Purificacao Monteiro
%J Clinical Ethics
%@ 1758-101X
%D 2018
%R 10.1177/1477750917738108
%X The acute-on-chronic exacerbations of end-stage respiratory diseases often result in prolonged hospital stays, relating these events to ethical conflicts in the fields of medical futility and distributive justice. This study aimed to understand patients¡¯ preferences for life-sustaining treatments when clinically stable and during regular follow-up visits, and to determine the factors that can influence these preferences. This was a prospective, observational, exploratory study using convenience sampling. Over a three-year period, the study enrolled 106 adult outpatients with end-stage pulmonary disease on long-term oxygen treatment with/without noninvasive mechanical ventilation with dyspnoea scores of 6 or more in the modified Borg dyspnoea scale and one of the following: Gold (chronic obstructive pulmonary disease classification) stage IV, diffusing capacity (DLCO) <40%, heart failure (New York Heart Association functional classification (NYHA)) stage III/IV, or systolic pulmonary artery pressure ¡İ40£¿mm Hg. Factors that were influential in preferences were age, gender, household status, NYHA class, and previous exposure to mechanical ventilation. There was no consensus on life-sustaining treatment preferences. Demographic factors, such as age group, gender, household status, severity of disease, and previous treatment with mechanical ventilation, seemed to affect patients¡¯ preferences
%K Advance directives
%K clinical ethics
%K attitudes to death
%K death and dying
%K clinical ethics
%K informed consent
%K clinical ethics
%K treatment refusal
%K clinical ethics
%U https://journals.sagepub.com/doi/full/10.1177/1477750917738108