About a quarter of patients hospitalized with congestive heart failure would prefer that they not be revived if their hearts stopped beating, a new study shows, but their physicians were often unaware of their wishes.
The Yale University study focused on more than 900 patients over a five-year period and found that 23 percent said they would prefer not to be resuscitated while 69 said they wanted to be resuscitated. Eight percent weren’t sure what they wanted.
When the physicians treating these patients were questioned, about one-fourth of them guessed wrong when asked about patient preference on the resuscitation issue. Even doctors who had discussed the matter with the patients often guessed wrong, researchers found.
One reason for the confusion may be that patients themselves change their minds on the question. The study found that when patients were questioned about resuscitation after leaving the hospital, 19 percent had changed their minds.
While most people with terminal illnesses like cancer or AIDS tend to get worse before death, congestive heart failure often has a different pattern, said Dr. Harlan Krumholz, a Yale cardiologist, the principle author of the study in the journal Circulation.
“With other diseases, people feel sicker and sicker each day as they get closer to death,” Krumholz said. “Congestive heart failure patients may be hospitalized several times, but in between these periods, they often feel much better. This may explain why we see far more patients wanting resuscitation. When their symptoms fade for awhile, they are able to regain their hope of surviving.”
Reducing teen pregnancies
Physicians could play a big role in reducing teenaged pregnancies if they’d be more active educating young people about the so-called “morning after pill” that can prevent a pregnancy even when taken after unprotected sex, researchers suggest.
In the August issue of the Archives of Pediatrics and Adolescent Medicine, California researchers report that only about one-quarter of teens apparently even know that contraception is possible after sexual activities. The researchers at the Henry J. Kaiser Family Foundation in Menlo Park questioned more than 1,500 teen-agers to learn their knowledge level on the topic.
If initiated within 72 hours of unprotected sex, high doses of oral contraceptives taken in two doses can reduce the risk of pregnancy by 75 percent. After learning such things exist, about two-thirds of the teenaged girls in the survey said they were interested in using them.
“Health care professionals could take a more proactive role by telling their patients about the pills and providing them both in advance of and in response to emergency situations,” the Kaiser researchers concluded. “Only with greater awareness can the potential for emergency contraception be realized.”
