Life-sustaining technology and the elderly. Prolonged mechanical ventilation factors influencing the treatment decision.
Abstract
In 1985, the Office of Technology Assessment (OTA) was requested by the House and Senate Aging Committees (US Congress) to study implications of life-sustaining technology and the elderly. One concern was mechanical ventilation of patients with critical illness or terminal conditions. Information was requested concerning the factors that influence treatment decisions. This report brings together opinions from medical experts in focus groups about a variety of issues raised by the OTA. The answers to those questions represent the therapeutic dilemma facing the decision-maker dealing with the elderly patient and a condition of prognostic uncertainty. Although a variety of responses is presented, some uniform trends among experts are evident. Considering the current public policy debate concerning catastrophic and long-term care of the elderly, the need is apparent to establish a clearing-house of information providing documentation, education, and networking. A documentation center would serve as a resource for public policy and program planning to serve the population that requires prolonged mechanical ventilation.
