Urban people’s preferences for life-sustaining treatment or artificial nutrition and hydration in advance decisions

Abstract Objectives This study investigated the preferences of AD, consistency, and differences in LST and ANH preferences, and factors affecting LST and ANH selection among urban residents. Research Methodology: A retrospective observational design and Convenience sampling were utilized in this study. Data of 2337 individuals with legal ability who were at least 20 years old and attended the ACP consultations from January 5 to January 6, 2020, were retrieved from the electronic records. Setting: Taiwan's Patient Right to Autonomy Act was put into effects in 2019 and allowed the signing of advance decisions (AD) through advance care planning (ACP). Withhold and withdrawal from life-sustaining treatment (LST) or artificial nutrition and hydration (ANH) treatment are now allowed for anyone to be in a condition of irreversible coma, vegetative state, severe dementia, or unbearable pain. Main Outcome Measures: Preferences of life-sustaining treatment and artificial nutrition/hydration, clinical conditions, differences from participants' preferences, and factors associated with preference Results High consistency was found in the willingness of refusing LST and ANH which differed significantly between the terminal diseases and extremely severe dementia. Besides, ANH was widely accepted as a time-limited treatment as well as authorizing health care agent to make decisions on behalf of the patients. Conclusion Significant differences were found in gender, age, and consultation intention in not wishing the family to take responsibility in making decisions. Influential factors involved cultural impacts and demographics.