{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T05:03:42Z","timestamp":1763183022130,"version":"3.45.0"},"reference-count":30,"publisher":"Scientific Scholar","content-domain":{"domain":["jpalliativecare.com"],"crossmark-restriction":true},"short-container-title":["IJPC"],"abstract":"\n Objectives:<\/jats:title>\n In Thailand, family physicians play a central role in palliative care, which often includes the withdrawal of mechanical ventilation (WMV) as part of life-sustaining treatment cessation. However, the rationale behind these decisions varies significantly among practitioners. This study examines key factors that influence Thai family physicians\u2019 decisions to discontinue mechanical ventilation for terminally ill patients.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n We conducted an online survey from December 2021 to January 2022, employing a customised questionnaire. Its content validity and reliability were affirmed, achieving Cronbach\u2019s alpha scores of 0.81 and 0.88 in separate sections.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among 164 respondents, 123 (75%) had previously participated in WMV decisions. Key influencing factors included the involvement of family or surrogate decision-makers (SDMs), physicians\u2019 experience with end-of-life care and patients\u2019 explicit opposition to ventilator support. Urgent requests from families or SDMs and the imminence of patient mortality were also pivotal. A consensus on the ethical appropriateness of WMV was observed. Notably, physicians with over 3 years of experience in palliative care were significantly more likely to discontinue ventilation (odds ratio [OR] = 5.30;\n P<\/jats:italic>\n = 0.001), a likelihood further increased by formal training in this area (OR = 8.97;\n P<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The decisions of Thai family physicians to cease mechanical ventilation in terminally ill patients are strongly influenced by family or SDMs\u2019 input, their own experiential background and the expressed wishes of the patients regarding ventilator assistance.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/ijpc_333_2024","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T06:49:47Z","timestamp":1757054987000},"page":"332-341","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Family Physicians\u2019 Decision-making in Mechanical Ventilation Withdrawal: A Cross-sectional Study"],"prefix":"10.25259","volume":"31","author":[{"given":"Tunwarat","family":"Pankaew","sequence":"first","affiliation":[{"name":"Department of Social Medicine, Medical Education Center Buddhasothorn Hospital, Chachoengsao, Thailand,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruankwan","family":"Kanhasing","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Ramathibodi Hospital, Mahidol University, Ratchatewi, Bangkok, Thailand,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wadee","family":"Wongpradit","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"10.25259\/IJPC_333_2024\/ref-2","doi-asserted-by":"publisher","first-page":"1572","DOI":"10.1007\/s00134-015-3810-5","article-title":"Global Variability in Withholding and Withdrawal of Life-Sustaining Treatment in the Intensive Care Unit: A Systematic Review","volume":"41","author":"Mark","year":"2015","journal-title":"Intensive Care Med"},{"key":"10.25259\/IJPC_333_2024\/ref-3","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/1471-227X-11-12","article-title":"Withholding and Withdrawing Life-Sustaining Therapy in a Moroccan Emergency Department: An Observational Study","volume":"11","author":"Damghi","year":"2011","journal-title":"BMC Emerg Med"},{"key":"10.25259\/IJPC_333_2024\/ref-4","doi-asserted-by":"publisher","first-page":"1744","DOI":"10.1007\/s00134-001-1111-7","article-title":"Withdrawing and Withholding Life Support in the Intensive Care Unit: A Spanish Prospective Multi-Center Observational Study","volume":"27","author":"Esteban","year":"2001","journal-title":"Intensive Care Med"},{"key":"10.25259\/IJPC_333_2024\/ref-5","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1056\/NEJM199002013220506","article-title":"Withholding and withdrawal of life support from the critically ill","volume":"322","author":"Smedira","year":"1990","journal-title":"N Engl J Med"},{"key":"10.25259\/IJPC_333_2024\/ref-6","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1056\/NEJMoa030083","article-title":"Withdrawal of Mechanical Ventilation in Anticipation of Death in the Intensive Care Unit","volume":"349","author":"Cook","year":"2003","journal-title":"N Engl J Med"},{"key":"10.25259\/IJPC_333_2024\/ref-7","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1378\/chest.106.3.880","article-title":"The Clinical Management of Dying Patients Receiving Mechanical Ventilation. 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