Evid Based Nurs 15:9 doi:10.1136/ebnurs-2011-100148
  • Nursing issues
  • Survey

Best interest standards do not correlate with the reality of physicians' decision making in life and death choices

  1. Antoine Payot
  1. Department of Pediatrics, CHU Sainte-Justine, Montreal, Canada
  1. Correspondence to Antoine Payot
    Department of Pediatrics, CHU Sainte-Justine, 3175, Côte-Ste-Catherine, Montreal, QC H3T 1C5, Canada; antoine.payot{at}

Commentary on:

Implications for nursing practice and research

  • Clinicians appear to take decisions relating to resuscitation and non-resuscitation that do not always adhere to the best interest standard used in clinical ethical guidelines.

  • Discrepancies between best interest valuation and the respect of families' requests not to resuscitate shows that shared decision making is lacking in most cases.

  • There is a need for a shared decision making process with all patients and surrogates.

  • Further research is needed to explore decision making in this context.


The best interests standard is widely used in clinical ethical guidelines to frame emergency medicine practice in the absence of guidance by patients or their family. It is at the heart of the beneficence …

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