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Physicians' experiences with end-of-life decision-making: Survey in 6 European countries and Australia

Loefmark, Rurik; Nilstun, Tore LU ; Cartwright, Colleen; Fischer, Susanne; van der Heide, Agnes; Mortier, Freddy; Norup, Michael; Simonato, Lorenzo and Onwuteaka-Philipsen, Bregje D (2008) In BMC Medicine 6(4).
Abstract
Background: In this study we investigated (a) to what extent physicians have experience with performing a range of end-of-life decisions (ELDs), (b) if they have no experience with performing an ELD, would they be willing to do so under certain conditions and (c) which background characteristics are associated with having experience with/or being willing to make such ELDs. Methods: An anonymous questionnaire was sent to 16,486 physicians from specialities in which death is common: Australia, Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. Results: The response rate differed between countries (39-68%). The experience of foregoing life-sustaining treatment ranged between 37% and 86%: intensifying the alleviation of pain or... (More)
Background: In this study we investigated (a) to what extent physicians have experience with performing a range of end-of-life decisions (ELDs), (b) if they have no experience with performing an ELD, would they be willing to do so under certain conditions and (c) which background characteristics are associated with having experience with/or being willing to make such ELDs. Methods: An anonymous questionnaire was sent to 16,486 physicians from specialities in which death is common: Australia, Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. Results: The response rate differed between countries (39-68%). The experience of foregoing life-sustaining treatment ranged between 37% and 86%: intensifying the alleviation of pain or other symptoms while taking into account possible hastening of death between 57% and 95%, and experience with deep sedation until death between 12% and 46%. Receiving a request for hastening death differed between 34% and 71%, and intentionally hastening death on the explicit request of a patient between 1% and 56%. Conclusion: There are differences between countries in experiences with ELDs, in willingness to perform ELDs and in receiving requests for euthanasia or physician-assisted suicide. Foregoing treatment and intensifying alleviation of pain and symptoms are practiced and accepted by most physicians in all countries. Physicians with training in palliative care are more inclined to perform ELDs, as are those who attend to higher numbers of terminal patients. Thus, this seems not to be only a matter of opportunity, but also a matter of attitude. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
BMC Medicine
volume
6
issue
4
publisher
BioMed Central
external identifiers
  • wos:000254554900001
  • scopus:41749098829
ISSN
1741-7015
DOI
10.1186/1741-7015-6-4
language
English
LU publication?
yes
id
db4d35ca-49be-429d-928a-4db012388f4d (old id 1183033)
alternative location
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2277432
date added to LUP
2008-09-02 11:06:27
date last changed
2017-10-22 04:10:15
@article{db4d35ca-49be-429d-928a-4db012388f4d,
  abstract     = {Background: In this study we investigated (a) to what extent physicians have experience with performing a range of end-of-life decisions (ELDs), (b) if they have no experience with performing an ELD, would they be willing to do so under certain conditions and (c) which background characteristics are associated with having experience with/or being willing to make such ELDs. Methods: An anonymous questionnaire was sent to 16,486 physicians from specialities in which death is common: Australia, Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. Results: The response rate differed between countries (39-68%). The experience of foregoing life-sustaining treatment ranged between 37% and 86%: intensifying the alleviation of pain or other symptoms while taking into account possible hastening of death between 57% and 95%, and experience with deep sedation until death between 12% and 46%. Receiving a request for hastening death differed between 34% and 71%, and intentionally hastening death on the explicit request of a patient between 1% and 56%. Conclusion: There are differences between countries in experiences with ELDs, in willingness to perform ELDs and in receiving requests for euthanasia or physician-assisted suicide. Foregoing treatment and intensifying alleviation of pain and symptoms are practiced and accepted by most physicians in all countries. Physicians with training in palliative care are more inclined to perform ELDs, as are those who attend to higher numbers of terminal patients. Thus, this seems not to be only a matter of opportunity, but also a matter of attitude.},
  author       = {Loefmark, Rurik and Nilstun, Tore and Cartwright, Colleen and Fischer, Susanne and van der Heide, Agnes and Mortier, Freddy and Norup, Michael and Simonato, Lorenzo and Onwuteaka-Philipsen, Bregje D},
  issn         = {1741-7015},
  language     = {eng},
  number       = {4},
  publisher    = {BioMed Central},
  series       = {BMC Medicine},
  title        = {Physicians' experiences with end-of-life decision-making: Survey in 6 European countries and Australia},
  url          = {http://dx.doi.org/10.1186/1741-7015-6-4},
  volume       = {6},
  year         = {2008},
}