%0 Journal Article
%T Preferences for Life-Sustaining Treatment and Artificial Nutrition in Advance Decisions: An Urban Population Study
%A Ki Yao
%A Yuan Cai
%J Asian Journal of Ethics in Health and Medicine
%@ 3108-5059
%D 2022
%V 2
%N 1
%R 10.51847/F8tzZEuEp4
%P 23-35
%X The Patient Right to Autonomy Act (PRAA), enacted in Taiwan in 2019, allows individuals to establish advance decisions (ADs) through advance care planning (ACP). This law permits withholding or withdrawing life-sustaining treatment (LST) or artificial nutrition and hydration (ANH) under conditions such as irreversible coma, vegetative state, advanced dementia, or intolerable suffering. This study explores urban residents’ preferences regarding LST and ANH in different clinical scenarios, variations in these choices, and the factors that influence them. A survey of legally formatted AD documents was conducted using convenience sampling. Participants were recruited from Taipei City Hospital, which has served as the main ACP pilot and demonstration center since the PRAA’s implementation. Data were drawn from ADs and ACP consultation records, covering demographic and clinical variables such as age, gender, welfare status, medical conditions, caregiving experience, ACP consultation site, participation of relatives, and willingness to engage in ACP. Records from 2337 individuals were analyzed. Most participants consistently preferred to refuse both LST and ANH, though significant differences emerged between terminal illness and severe dementia scenarios. Many participants favored ANH as a temporary measure, and appointing a health care agent (HCA) was a common practice. Gender differences were notable: women more often declined LST and ANH, whereas men leaned toward accepting full or limited treatment. Age also influenced decisions, with younger individuals more likely to pursue treatment and designate an HCA, while older participants were more inclined to refuse interventions. Preferences for LST and ANH were shaped by awareness of clinical conditions as well as demographic and cultural factors. The findings highlight the complexity of end-of-life choices, the evolution of ADs, and the role of socio-demographics in shaping them. Future research should examine how preferences shift over time and how healthcare professionals approach LST and ANH decisions, particularly in neurological conditions.
%U https://smerpub.com/article/preferences-for-life-sustaining-treatment-and-artificial-nutrition-in-advance-decisions-an-urban-po-fi15lp0ge8kobva