Classification of end-of-life decisions by dutch physicians:Findings from a cross-sectional survey

Background: At the end of patients’ lives, physicians sometimes provide medication with the explicit intention to hasten death. Physicians’ assessment of such acts varies. We studied which characteristics are associated with physicians’ classification of these acts. Methods: This study concerns a secondary analysis of a nationwide study on the practice of medical decision-making at the end of life. In 2015, attending physicians of a sample of deceased people (n=9,351) received a questionnaire about end-of-life care and decision-making. The response rate was 78%. We studied 851 cases in which p... Mehr ...

Verfasser: Overbeek, Anouk
van de Wetering, Veerle E.
van Delden, Johannes J.M.
Mevis, Paul A.M.
Onwuteaka-Philipsen, Bregje D.
Postma, Liselotte
Rietjens, Judith A.C.
van der Heide, Agnes
Dokumenttyp: Artikel
Erscheinungsdatum: 2021
Reihe/Periodikum: Overbeek , A , van de Wetering , V E , van Delden , J J M , Mevis , P A M , Onwuteaka-Philipsen , B D , Postma , L , Rietjens , J A C & van der Heide , A 2021 , ' Classification of end-of-life decisions by dutch physicians : Findings from a cross-sectional survey ' , Annals of palliative medicine , vol. 10 , no. 3 , pp. 3554-3562 . https://doi.org/10.21037/apm-20-453
Schlagwörter: /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being / SDG 3 - Good Health and Well-being
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29043486
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://pure.eur.nl/en/publications/0895f724-3507-4db1-93ab-a2ead881b766

Background: At the end of patients’ lives, physicians sometimes provide medication with the explicit intention to hasten death. Physicians’ assessment of such acts varies. We studied which characteristics are associated with physicians’ classification of these acts. Methods: This study concerns a secondary analysis of a nationwide study on the practice of medical decision-making at the end of life. In 2015, attending physicians of a sample of deceased people (n=9,351) received a questionnaire about end-of-life care and decision-making. The response rate was 78%. We studied 851 cases in which physicians reported that the patient had died as a result of medication they had provided with the explicit intention to hasten death. Chi-square tests and logistic regression analyses were performed. Results: If medication had been provided with the explicit intention to hasten death at the explicit request of the patient, physicians considered “euthanasia”, “assisted suicide” or “ending of life” the most appropriate term for their course of action in 82% of all cases, while 17% of physicians chose the term “palliative or terminal sedation”. Physicians’ classification of their act as “euthanasia”, “assisted suicide” or “ending of life” was less likely when patients had a short (1–7 days) or very short (max. 24 hours) life expectancy. Furthermore, such classification was less likely when their act had involved the use of other medication than muscle relaxants. The limited number of cases in which patients had been provided with medication without an explicit patient request were never classified as “euthanasia”, “assisted suicide” or “ending of life”. Conclusions: Physicians rarely classify the provision of medication with the explicit intention of hastening death as “euthanasia”, “assisted suicide” or “ending of life” when patients are in the dying phase and when they provide other medication than muscle relaxants. In these cases, acts are mostly classified as “palliative or terminal sedation”. This suggests that the legal ...