Table 3 The way advance directives are considered during cardiopulmonary resuscitation, individual interviews
Core theme | Subtheme | Exemplary quotes |
|---|---|---|
1. Reflexion | 1a. Time | “we need time” IND-Physician14 “you don’t have time, you’re fighting for it” IND-Physician12 “time spent in analysis […] is time wasted” IND-Physician5 “because we’re already late” IND-Physician2 |
1b. Responsibility | “you’re alone to make decisions” IND-Physician10 “the idea is to surround yourself with other physicians” IND-Physician8 “staying alone is not possible” IND-Physician3 | |
2. Assessment of the medical situation | 2a. Patient | “young person in good health with no previous history” IND-Physician15 |
2b. Phenomenon | “sudden cardiac arrest” IND-Physician11 | |
2c. Prognosis | “very good recovery potential” IND-Physician6 “will be in a vegetative state at best” IND-Physician9 | |
2d. Judgement | “I dismiss the AD because it is inappropriate” IND-Physician11 | |
3. Determining the validity of ADs | 3a. Authentication | “verification of data and identity” IND-Physician10 |
3b. Wishes | “I still need to be certain that this AD corresponds to the patient’s wishes. And I can’t be sure of that at all because he’s unconscious.” IND-Physician12 | |
3c. Knowledge | “I don’t know if he wrote them with full medical knowledge of what these terms would mean for him” IND-Physician4 | |
3d. Discernment | “under the influence of toxic substances, suffering from a psychiatric pathology, impaired judgement or cognitive disorder?” IND-Physician5 | |
3e. Delivery method | “I don’t know where it came from, it could have been signed by anyone” IND-Physician13 | |
3 f. Legal | “I don’t know what’s legal and what isn’t when it comes to ADs” IND-Physician8 | |
3 g. New situation | “a situation I’ve never experienced before” IND-Physician12 | |
3 h. Opinions of relatives | “I would try to contact other people, members of his family, people close to him.” IND-Physician4 | |
4. Cognitive dissonance | 4a. ADs in a healthy person | “this AD which is based on nothing” IND-Physician14 “I’m… shocked, I find it hard to understand” IND-Physician8 “a very destabilising situation” IND-Physician12 “it’s assisted suicide” IND-Physician3 “that makes sense […] it raises some good questions” IND-Physician9 |
4b. Searching for a Reason | “why did he write ADs?” IND-Physician1 “I don’t know why he doesn’t want to be resuscitated” IND-Physician13 “we don’t have to understand, but it would help the team buy into the project" IND-Physician5 | |
4c. Not doing something I can do | “we want to resuscitate this person” IND-Physician1 “I’d have trouble accepting not doing anything, it would be very difficult for me, as a physician” IND-Physician2 “I’m here to treat, so I’m doing my job” IND-Physician7 “it’ll be a bit binary and very instinctive, as a physician […], I’m going to start doing what I was trained for” IND-Physician4 “I start CPR, and figure it out afterwards” IND-Physician8 |