Ethical attitudes of non-intensive care unit clinicians upon end-of-life issue: more training is necessary.

received, with an overall response rate of slightly above 50%. One of the major findings from our survey is that more clinicians from medical specialties than surgical specialties have ever used the form and issued DNR orders (surgical 58.3% vs medical 90.2%, χ 2 (3)=16, P<0.001). Compared with the finding of Yap et al, 1 where 95% of ICU physicians gave verbal or written DNR orders, it seems that the practice of DNR for medical non-ICU clinicians is similar to that for ICU physicians. Another interesting finding is that clinicians of Department of Medicine with experience of 8 years or more are more successful in convincing the relatives to accept DNR (χ 2 (3)=7.93, P<0.05), though that was unrelated to their ranks. The respondents widely accepted that when managing patients decided for DNR, morphine can be administered for the relief of respiratory distress (82%), with no further invasive procedures (78%) or intubation (100%). However, the degrees of acceptance for administering broad-spectrum antibiotics (21%) and blood product transfusion (32%) are more divided in these scenarios. Clinicians with less than 8 years’ experience had less agreement with regard to the giving of antibiotics to patients decided for DNR (χ 2 (4)=17.8, P<0.001), while more medical clinicians agreed with regard to blood transfusion (χ 2 (4)=11.9, P<0.05).