What do physicians tell patients with end-stage COPD about intubation and mechanical ventilation?
GROUND: At some point in time, many patients with end-stage COPD require intubation and mechanical ventilation (MV) to sustain life. MV decisions are most effective when the patient and physician have discussed the options in advance. The purpose of this study was to examine how the physician perceives the decision-making process. METHODS: Fifteen respirologists were interviewed to elicit information regarding intubation and MV, and the exchange of information between patients and physicians. Emergent themes were coded using a qualitative approach and were verified by a blinded researcher. RESULTS: Respondents included ten academic and five community-based respirologists from seven hospitals. Most physicians were men with between 4 and 37 years experience. Narratives were very similar in content and seemed well rehearsed. Approach and delivery, however, were unique to each physician. Fourteen respirologists emphasized the importance of knowing patients as individuals prior to initiatin
