scholarly journals Classification of end-of-life decisions by Dutch physicians: findings from a cross-sectional survey

2020 ◽  
Vol 9 (6) ◽  
pp. 7-7
Author(s):  
Anouk Overbeek ◽  
Veerle E. van de Wetering ◽  
Johannes J. M. van Delden ◽  
Paul A. M. Mevis ◽  
Bregje D. Onwuteaka-Philipsen ◽  
...  
Keyword(s):  
End Of Life ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
End Of Life Decisions ◽  
Life Decisions

scholarly journals Withholding treatment and intellectual disability: Second survey on end-of-life decisions in Switzerland

2016 ◽  
Vol 4 ◽  
pp. 205031211665263 ◽  
Author(s):  
Monika T Wicki
Keyword(s):  
Decision Making ◽  
Intellectual Disability ◽  
End Of Life ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residential Homes ◽  
End Of Life Decisions ◽  
Life Decisions ◽  
End Of Life Decision ◽  
Life Decision

Background: As people live longer, they are more likely to die over a prolonged period from incurable, chronic illnesses that occur more frequently in old age. Therefore, people will experience an increase in end-of-life discussions and decisions. Aim: The aim of this study was to explore the prevalence and nature of end-of-life decisions for people with disabilities in Swiss residential homes. Design: A cross-sectional survey in the three biggest German-speaking regions in Switzerland (N = 209) was conducted. Setting: All of the residential homes for adults with disabilities (N = 209) were invited to participate in a cross-sectional survey. The response quote was 76.7%. Directors provided information on 82 deaths. Chi-square and t-tests were used to study differences in prevalence and nature of end-of-life decisions between people with intellectual disability (ID) and people with other disabilities. Results: An end-of-life decision was taken in 53.7% of the cases (n = 44). For people with ID, the decision to withhold treatment had been taken more often (28.9%, 13 cases) than for people with other disabilities (8.1%, 3 cases) (χ2 (1, N = 82) = 5.58, p = 0.017). Conclusion: The study provides insight in end-of-life decision-making for people with disabilities in Switzerland. The results have implications on surrogate decision-making for people with ID living in residential homes. As the study partly confirms the results of previous studies, further studies will be necessary.

scholarly journals End-of-life decisions in Slovenian ICUs: a cross-sectional survey

Critical Care ◽  
2013 ◽  
Vol 17 (S2) ◽  
Author(s):  
S Grosek ◽  
M Orazem ◽  
M Kanic ◽  
G Vidmar ◽  
U Groselj
Keyword(s):  
End Of Life ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
End Of Life Decisions ◽  
Life Decisions

A classification of end-of-life decisions in neonates and infants

2007 ◽  
Vol 93 (3) ◽  
pp. 301-305 ◽  
Author(s):  
V Provoost ◽  
L Deliens ◽  
F Cools ◽  
PG Deconinck ◽  
J Ramet ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Decisions ◽  
Life Decisions ◽  
Neonates And Infants

End-of-life decisions and appropriateness of care in intensive care: a cross-sectional, pilot study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Cescon ◽  
E Monaco ◽  
D Gregori ◽  
M Martinato
Keyword(s):  
Intensive Care ◽  
Pilot Study ◽  
End Of Life ◽  
Life Support ◽  
High Rate ◽  
Cross Sectional ◽  
End Of Life Decisions ◽  
Inappropriate Care ◽  
Organ Failures ◽  
Life Decisions

Abstract In Intensive Care Units (ICUs) patients can experience severe organ failures. In several cases, failures can be incurable, making many of the treatments inappropriate, according to ethical principles. Based on the current legislation, in ICUs, clinicians proceed to limit life support care in most of the cases described. Despite this, some studies report that in many cases the care provided is inappropriate for the prognosis. The study aims at investigating the type and frequency of healthcare personnel's End of Life Decisions (DEL) and the point of view of patients' family, contributing to the debate. A non-interventional cross-sectional pilot study was conducted in 3 ICUs in North-Eastern Italy. Two questionnaires were administered: the first investigates DEL and the perception of nurses and physicians regarding the inadequacy of care provided to patients (from the ELDY study), the second focuses on the family's opinions. Data are expressed by frequencies, percentages, means and standard deviations. In line with most of previous studies, cases identified as DEL are all related to non-treatment decisions (n = 20, 74%), 44% of these are related to having stopped or not started treatments already knowing the possibility of anticipating the end of life of the patient, while 27% had the precise intention of shortening life. The situation has been discussed with patient's relatives only in two cases. The cause of increased inappropriateness (87%) was the perception that other patients would benefit more from intensive care than the patient in charge, and 40% of the healthcare personnel reported that similar situations occur very frequently. The restriction of treatment has been confirmed as the most frequent DEL, and interruption being more frequent than non-implementation. Given the high rate of inappropriate care, it could be effective to follow adequate guidelines in the management of the DEL and discuss strategies within the team and with patients' family. Key messages When severe organ failures are incurable, in ICUs clinicians proceed to limit life support to the patient in charge. Despite this, in many cases the care provided is inappropriate for the prognosis. Given the high rate of inappropriate care, it could be effective to follow adequate guidelines in the management of the DEL and discuss strategies within the team and with patients’ family.

scholarly journals Assisted life termination and truth telling to terminally ill patients – a cross-sectional study of public opinions in Israel

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Moran Bodas ◽  
Baruch Velan ◽  
Giora Kaplan ◽  
Arnona Ziv ◽  
Carmit Rubin ◽  
...  
Keyword(s):  
End Of Life ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Truth Telling ◽  
Cross Sectional ◽  
Assisted Death ◽  
End Of Life Decisions ◽  
Public Opinions ◽  
Israeli Population ◽  
Life Decisions

Abstract Background End-of-life decisions are highly complex socio-normative and ethical phenomena. The goal of this study was to provide an assessment of public opinions in Israel concerning aspects of end-of-life decisions. Methods An online cross sectional study was performed in February 2020. The primary tool including items pertaining to death assistance and truth telling to patients. A sample of 515 participants representative of the adult Israeli population was obtained. Results The majority of participants (71%) supports telling the entire truth to patients even in harsh conditions. Support for truth telling decreases with affiliation to religion, with as little as 40% support among ultra-orthodox. People with vocational education are the least supportive of truth telling. Concerning doctor assisted death, almost half (49%) of the sample were supportive. Opposition is positively associated with religiosity, with 90% of ultra-orthodox and 58% of religious participants opposing doctor-assisted death, compared to only 18% among seculars. Non-Jews were 3.35 times (95%CI: 1.90, 5.91) more likely to oppose doctor assisted death than Jews (p < .0001). An Interrelationship analysis crossing between attitudes revealed that the largest group (39%) was comprised of participants who support both (“autonomists”). Conclusions Israelis are overwhelmingly supportive of truth telling to patients. In contrast, Israeli public opinions on doctor assisted death are divided. For both attitudes, religiousness plays a crucial role as a catalyst for conservatism and opposition to change. Almost a half of the public is also supportive of an autonomist approach that would allow patients to decide on ending their own lives.

scholarly journals End-of-life decision making by Austrian physicians - a cross-sectional study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
D. Jahn-Kuch ◽  
A. Domke ◽  
S. Bitsche ◽  
H. Stöger ◽  
A. Avian ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Palliative Medicine ◽  
Symptom Relief ◽  
Postal Survey ◽  
Cross Sectional ◽  
End Of Life Decisions ◽  
Legal Situation ◽  
Additional Qualification ◽  
Life Decisions

Abstract Background Austria has recently been embroiled in the complex debate on the legalization of measures to end life prematurely. Empirical data on end-of-life decisions made by Austrian physicians barely exists. This study is the first in Austria aimed at finding out how physicians generally approach and make end-of-life therapy decisions. Methods The European end-of-life decisions (EURELD) questionnaire, translated and adapted by Schildmann et al., was used to conduct this cross-sectional postal survey. Questions on palliative care training, legal issues, and use of and satisfaction with palliative care were added. All Austrian specialists in hematology and oncology, a representative sample of doctors specialized in internal medicine, and a sample of general practitioners, were invited to participate in this anonymous postal survey. Results Five hundred forty-eight questionnaires (response rate: 10.4%) were evaluated. 88.3% of participants had treated a patient who had died in the previous 12 months. 23% of respondents had an additional qualification in palliative medicine. The cause of death in 53.1% of patients was cancer, and 44.8% died at home. In 86.3% of cases, pain relief and / or symptom relief had been intensified. Further treatment had been withheld by 60.0%, and an existing treatment discontinued by 49.1% of respondents. In 5 cases, the respondents had prescribed, provided or administered a drug which had resulted in death. 51.3% of physicians said they would never carry out physician-assisted suicide (PAS), while 30.3% could imagine doing so under certain conditions. 38.5% of respondents supported the current prohibition of PAS, 23.9% opposed it, and 33.2% were undecided. 52.4% of physicians felt the legal situation with respect to measures to end life prematurely was ambiguous. An additional qualification in palliative medicine had no influence on measures taken, or attitudes towards PAS. Conclusions The majority of doctors perform symptom control in terminally ill patients. PAS is frequently requested but rarely carried out. Attending physicians felt the legal situation was ambiguous. Physicians should therefore receive training in current legislation relating to end-of-life choices and medical decisions. The data collected in this survey will help political decision-makers provide the necessary legal framework for end-of-life medical care.

scholarly journals Attitudes of the Equestrian Public towards Equine End-of-Life Decisions

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1776
Author(s):  
Catherine Bell ◽  
Suzanne Rogers
Keyword(s):  
End Of Life ◽  
Affective State ◽  
Principal Component ◽  
Peer Pressure ◽  
Negative Attitudes ◽  
End Of Life Decisions ◽  
Life Decisions ◽  
End Of Life Decision ◽  
Physical Reasons ◽  
Horse Owners

A key welfare concern for the equine population in the U.K. has been identified as delayed death, leading to prolonged suffering of horses. Reasons why some horse owners fail to have their horses euthanised include financial cost, emotional attachment, peer pressure, negative attitudes towards killing and poor recognition of behavioural indicators of equine pain and stress. The Five Freedoms framework of welfare was used to build a Likert-style survey to investigate the factors underlying attitudes of horse owners towards welfare measures in an end-of-life decision. Participants were asked to respond to hypothetical welfare scenarios and to give details of any horses they had had euthanised. The survey was conducted predominantly via equestrian Facebook groups and obtained 160 participant responses. Reliability of the scale was acceptable, with Cronbach’s α=0.89. Principal Component Analysis was used to load the hypothetical scenarios onto seven factors containing 62.2% of the variance. The first four factors could be categorized according to “Ethology-informed Management”, “Traditional Horse Management”, “Emotional Issues” and “Physical Issues”. Participants were more likely to consider euthanasia for physical issues, compared with issues relating to affective state and/or ethology, although it was not clear whether this was due to disregard for welfare issues relating to mental health or failure to recognise them as such. A large number of responses stated that the scenario had no bearing on whether a horse should be euthanised, again suggesting a lack of recognition of welfare issues and their implications. When asked to state their reasons for euthanising their horses, participants cited almost exclusively physical reasons, with the exception of those citing dangerous behaviour. Only a small number of responses also included consideration of affective and/or ethological factors, suggesting that welfare issues concerning affective state and/or behaviour are at risk of omission from end-of-life decisions.

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