Do-not-resuscitate decision: the attitudes of medical and non-medical students

OBJECTIVES

To study the attitudes of both medical and non-medical students towards the do-not-resuscitate (DNR) decision in a university in Hong Kong, and the factors affecting their attitudes.

METHODS

A questionnaire-based survey conducted in the campus of a university in Hong Kong. Preferences and priorities of participants on cardiopulmonary resuscitation in various situations and case scenarios, experience of death and dying, prior knowledge of DNR and basic demographic data were evaluated.

RESULTS

A total of 766 students participated in the study. There were statistically significant differences in their DNR decisions in various situations between medical and non-medical students, clinical and preclinical students, and between students who had previously experienced death and dying and those who had not. A prior knowledge of DNR significantly affected DNR decision, although 66.4% of non-medical students and 18.7% of medical students had never heard of DNR. 74% of participants from both medical and non-medical fields considered the patient's own wish as the most important factor that the healthcare team should consider when making DNR decisions. Family wishes might not be decisive on the choice of DNR.

CONCLUSIONS

Students in medical and non-medical fields held different views on DNR. A majority of participants considered the patient's own wish as most important in DNR decisions. Family wishes were considered less important than the patient's own wishes.

Judgments of "normal" and "problem" alcohol use as related to reported alcohol consumption

We obtained alcohol use data and judgments of individual ("What do you think?") and cultural ("What do people in general think?") norms for normal and problem quantity and frequency of alcohol use, as well as ratings of whether particular alcohol-related behaviors indicated a drinking problem, from 928 adult respondents who were members of Hawaii's five major racial/ethnic groups [Chinese, European (Caucasian), Filipino, Hawaiian/Part-Hawaiian, and Japanese ancestry]. As compared with older survey data (but consonant with recent survey data), Hawaiians have substantially increased in alcohol use, as have Filipinos (if they drink at all; a high proportion are abstainers), and to a lesser extent, Japanese. Chinese remain very low in alcohol use, while Caucasians have relatively decreased in use. Alcohol use norms (especially of own judged normal use) vary across sexes and ethnic groups and are predictors of consumption both within and across groups. Family resemblances are substantial with regard to alcohol use category (present users, former drinkers, abstainers). Among present users, family resemblances are often significant with regard to amount used; resemblances are more substantial between mothers and offspring than between spouses or between fathers and offspring. There were small but significant ethnic group differences in the number of specific behaviors judged to be indicative of a drinking problem, with the groups reporting the highest mean alcohol consumption (Caucasians and Hawaiians/Part Hawaiians) also indicating more behaviors, particularly pathological as opposed to celebratory behaviors, as being problematic.(ABSTRACT TRUNCATED AT 250 WORDS)

Familial transmission of alcohol consumption and the flushing response to alcohol in three Oriental groups

Multivariate path analysis was used to examine the etiologies of variation and covariation of flushing after alcohol use in nuclear families of Korean, Taiwanese, Japanese and Caucasian ancestries. Phenotypic variances and covariances were partitioned into familial (additive genetic and common family environment) and environmental components. Although alcohol consumption and flushing varied greatly among the different groups, familialities, estimated from components of mother, father and at least one child, were remarkably similar. The familialities for flushing were 0.48 for Japanese, 0.56 for Koreans and 0.35 for Taiwanese; flushing is infrequent in Caucasians and thus was not analyzed. Familialities were lower for consumption, but like flushing, were consistent across ethnic groups (Japanese, 0.27; Koreans, 0.24; Taiwanese, 0.15; Caucasians, 0.28). The genetic correlation between flushing and alcohol consumption was high. Thus, to the extent that flushing influences alcohol consumption, the covariance is most likely genetic.