Gender and age disparity in the initiation of life-supporting treatments: a population-based cohort study
Abstract Background The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: (1) t...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-11-01
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| Series: | BMC Medical Ethics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12910-017-0222-9 |
| _version_ | 1818205269104001024 |
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| author | Peng-Sheng Ting Likwang Chen Wei-Chih Yang Tien-Shang Huang Chau-Chung Wu Yen-Yuan Chen |
| author_facet | Peng-Sheng Ting Likwang Chen Wei-Chih Yang Tien-Shang Huang Chau-Chung Wu Yen-Yuan Chen |
| author_sort | Peng-Sheng Ting |
| collection | DOAJ |
| description | Abstract Background The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: (1) to examine the relationship between age and the extracorporeal membrane oxygenation use; (2) to examine the relationship between age and the extracorporeal membrane oxygenation use; and (3) to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation. Methods This is a population-based, retrospective cohort study. Taiwan’s extracorporeal membrane oxygenation cases from 2000 to 2010 were collected. The annual incidence rate of extracorporeal membrane oxygenation use adjusting for both age and gender distribution for each year from 2000 to 2010 was derived using the population of 2000 as the reference population. The trend of extracorporeal membrane oxygenation use was examined using time-series linear regression analysis. We conducted joinpoint regression for estimating the trend change of extracorporeal membrane oxygenation use. Results The trends of extracorporeal membrane oxygenation use both for different gender groups, and for different age groups have been significantly increasing over time. Men were more likely to be supported by extracorporeal membrane oxygenation than women. Women’s perspectives toward life and death, and women’s perception of well-being may be associated with the phenomenon. In addition, the patients at the age of 65 or older were more likely to be supported by extracorporeal membrane oxygenation than those younger than 65. Family autonomy/family-determination, and the Confucian tradition of filial piety and respecting elders may account for this phenomenon. Conclusions This study showed gender and age disparities in the initiation of extracorporeal membrane oxygenation use in Taiwan, which may be accounted for by the cultural and societal values in Taiwan. For a healthcare professional who deals with patients’/family members’ medical decision-making to initiate life-supporting treatments, he/she should be sensitive not only to the legality, but also the societal and ethical issues involved. |
| first_indexed | 2024-12-12T03:54:27Z |
| format | Article |
| id | doaj.art-e9d3f03fd5cd45ff9a88eb94331d62f2 |
| institution | Directory Open Access Journal |
| issn | 1472-6939 |
| language | English |
| last_indexed | 2024-12-12T03:54:27Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Ethics |
| spelling | doaj.art-e9d3f03fd5cd45ff9a88eb94331d62f22022-12-22T00:39:18ZengBMCBMC Medical Ethics1472-69392017-11-011811910.1186/s12910-017-0222-9Gender and age disparity in the initiation of life-supporting treatments: a population-based cohort studyPeng-Sheng Ting0Likwang Chen1Wei-Chih Yang2Tien-Shang Huang3Chau-Chung Wu4Yen-Yuan Chen5Department of Medicine, National Taiwan University College of MedicineInstitute of Population Health Sciences, National Health Research InstitutesInstitute of Population Health Sciences, National Health Research InstitutesDepartment of Medical Education, Cathay General HospitalGraduate Institute of Medical Education and Bioethics, National Taiwan University College of MedicineGraduate Institute of Medical Education and Bioethics, National Taiwan University College of MedicineAbstract Background The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: (1) to examine the relationship between age and the extracorporeal membrane oxygenation use; (2) to examine the relationship between age and the extracorporeal membrane oxygenation use; and (3) to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation. Methods This is a population-based, retrospective cohort study. Taiwan’s extracorporeal membrane oxygenation cases from 2000 to 2010 were collected. The annual incidence rate of extracorporeal membrane oxygenation use adjusting for both age and gender distribution for each year from 2000 to 2010 was derived using the population of 2000 as the reference population. The trend of extracorporeal membrane oxygenation use was examined using time-series linear regression analysis. We conducted joinpoint regression for estimating the trend change of extracorporeal membrane oxygenation use. Results The trends of extracorporeal membrane oxygenation use both for different gender groups, and for different age groups have been significantly increasing over time. Men were more likely to be supported by extracorporeal membrane oxygenation than women. Women’s perspectives toward life and death, and women’s perception of well-being may be associated with the phenomenon. In addition, the patients at the age of 65 or older were more likely to be supported by extracorporeal membrane oxygenation than those younger than 65. Family autonomy/family-determination, and the Confucian tradition of filial piety and respecting elders may account for this phenomenon. Conclusions This study showed gender and age disparities in the initiation of extracorporeal membrane oxygenation use in Taiwan, which may be accounted for by the cultural and societal values in Taiwan. For a healthcare professional who deals with patients’/family members’ medical decision-making to initiate life-supporting treatments, he/she should be sensitive not only to the legality, but also the societal and ethical issues involved.http://link.springer.com/article/10.1186/s12910-017-0222-9Extracorporeal membrane oxygenationCardiopulmonary resuscitationLife-supporting treatmentTrendDisparity |
| spellingShingle | Peng-Sheng Ting Likwang Chen Wei-Chih Yang Tien-Shang Huang Chau-Chung Wu Yen-Yuan Chen Gender and age disparity in the initiation of life-supporting treatments: a population-based cohort study BMC Medical Ethics Extracorporeal membrane oxygenation Cardiopulmonary resuscitation Life-supporting treatment Trend Disparity |
| title | Gender and age disparity in the initiation of life-supporting treatments: a population-based cohort study |
| title_full | Gender and age disparity in the initiation of life-supporting treatments: a population-based cohort study |
| title_fullStr | Gender and age disparity in the initiation of life-supporting treatments: a population-based cohort study |
| title_full_unstemmed | Gender and age disparity in the initiation of life-supporting treatments: a population-based cohort study |
| title_short | Gender and age disparity in the initiation of life-supporting treatments: a population-based cohort study |
| title_sort | gender and age disparity in the initiation of life supporting treatments a population based cohort study |
| topic | Extracorporeal membrane oxygenation Cardiopulmonary resuscitation Life-supporting treatment Trend Disparity |
| url | http://link.springer.com/article/10.1186/s12910-017-0222-9 |
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