Table 3 Frequency of all the different medical end-of-life decisions in France by physicians’ characteristics (non sudden deaths)
Life prolonging treatment | Withholding treatment | Withdrawing treatment | Intensification of alleviation of symptoms | Administration of a medication to deliberately hasten death | No decision | Total deaths | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | n | % | n | % | ||
Gender | |||||||||||||
Man | 414 | 15.9 | 452 | 17.4 | 123 | 4.7 | 822 | 31.6 | 29 | 1.1 | 758 | 29.2 | 2598 |
Woman | 156 | 12.1 | 232 | 18.0 | 74 | 5.8 | 485 | 37.7 | 8 | 0.6 | 332 | 25.8 | 1287 |
. | 6 | 16.2 | 4 | 10.2 | 2 | 5.1 | 20 | 50.8 | 0 | 0.0 | 7 | 17.8 | 39 |
P value | 0.0074 | 0.4357 | 0.4072 | <0.0001 | 0.2600 | 0.0453 | |||||||
Age | |||||||||||||
Under 40 | 120 | 13.8 | 161 | 18.4 | 50 | 5.7 | 351 | 40.2 | 14 | 1.5 | 178 | 20.4 | 874 |
40-49 | 168 | 14.9 | 198 | 17.6 | 75 | 6.7 | 371 | 33.0 | 3 | 0.3 | 310 | 27.5 | 1125 |
50-59 | 200 | 14.7 | 237 | 17.5 | 56 | 4.1 | 424 | 31.3 | 14 | 1.0 | 424 | 31.3 | 1355 |
60 and over | 86 | 15.8 | 87 | 16.0 | 16 | 2.9 | 169 | 31.1 | 7 | 1.2 | 179 | 33.0 | 543 |
. | 3 | 9.6 | 5 | 18.1 | 2 | 7.2 | 11 | 39.8 | 0 | 0.0 | 7 | 25.3 | 28 |
P value | 0.8056 | 0.8511 | 0.0049 | 0.0002 | 0.0600 | <0.0001 | |||||||
Speciality | |||||||||||||
General practice | 142 | 11.0 | 229 | 17.7 | 47 | 3.6 | 410 | 31.7 | 13 | 1.0 | 450 | 34.8 | 1292 |
Intensive care | 136 | 29.1 | 58 | 12.4 | 58 | 12.4 | 147 | 31.4 | 5 | 1.0 | 64 | 13.7 | 468 |
Oncology | 13 | 7.1 | 17 | 9.5 | 6 | 3.4 | 96 | 53.9 | 6 | 3.1 | 41 | 23.0 | 178 |
Cardiology | 32 | 26.7 | 26 | 21.6 | 1 | 0.8 | 34 | 28.2 | 5 | 4.4 | 22 | 18.3 | 120 |
Surgery | 16 | 24.1 | 7 | 10.8 | 2 | 3.1 | 22 | 34.1 | 0 | 0.0 | 18 | 27.9 | 65 |
Geriatrics | 75 | 8.8 | 151 | 17.7 | 44 | 5.2 | 330 | 38.7 | 3 | 0.3 | 250 | 29.3 | 853 |
Emergency | 81 | 24.4 | 63 | 18.9 | 15 | 4.5 | 50 | 15.0 | 0 | 0.0 | 124 | 37.2 | 333 |
Neurology | 2 | 4.9 | 9 | 24.6 | 1 | 2.5 | 16 | 43.5 | 0 | 0.0 | 9 | 24.5 | 37 |
Other | 78 | 13.9 | 125 | 22.2 | 25 | 4.4 | 213 | 37.9 | 6 | 1.0 | 115 | 20.5 | 562 |
. | 1 | 4.2 | 3 | 14.4 | 2 | 9.6 | 11 | 52.7 | 0 | 0.0 | 4 | 19.2 | 21 |
P value | <0.0001 | 0.0014 | (<0.0001) | <0.0001 | 0.0003 | <0.0001 | |||||||
Work context | |||||||||||||
General practice | 93 | 12.2 | 135 | 17.7 | 21 | 2.8 | 201 | 26.4 | 10 | 1.3 | 301 | 39.5 | 761 |
Public hospital | 352 | 17.9 | 357 | 18.1 | 123 | 6.2 | 670 | 34.0 | 17 | 0.8 | 451 | 22.9 | 1970 |
Private hospital | 47 | 16.6 | 31 | 11.0 | 17 | 6.0 | 120 | 42.4 | 4 | 1.4 | 64 | 22.6 | 283 |
Medico-social, rehab. or LTC establishment | 16 | 6.9 | 51 | 21.7 | 7 | 3.0 | 99 | 42.1 | 0 | 0.0 | 62 | 26.4 | 235 |
Other | 20 | 9.2 | 30 | 13.6 | 11 | 5.0 | 78 | 35.4 | 2 | 1.0 | 79 | 35.8 | 221 |
Several work contexts | 44 | 10.6 | 77 | 18.7 | 19 | 4.6 | 138 | 33.5 | 4 | 1.1 | 130 | 31.5 | 412 |
. | 4 | 9.1 | 6 | 14.3 | 1 | 2.4 | 21 | 50.2 | 0 | 0.0 | 10 | 23.9 | 42 |
P value | <0.0001 | 0.0271 | 0.0544 | <0.0001 | (0.5054) | <0.0001 | |||||||
Size of agglomeration | |||||||||||||
<5000 | 55 | 8.5 | 118 | 18.4 | 25 | 3.9 | 212 | 33.0 | 10 | 1.6 | 222 | 34.6 | 642 |
5-10000 | 60 | 13.8 | 74 | 17.1 | 16 | 3.7 | 130 | 30.0 | 3 | 0.8 | 150 | 34.7 | 433 |
20-20000 | 72 | 15.2 | 84 | 17.8 | 20 | 4.2 | 153 | 32.4 | 5 | 1.1 | 138 | 29.2 | 472 |
20-100000 | 212 | 17.7 | 210 | 17.5 | 64 | 5.3 | 406 | 33.9 | 9 | 0.8 | 296 | 24.7 | 1197 |
100-200000 | 56 | 14.1 | 75 | 18.7 | 29 | 7.2 | 130 | 32.4 | 2 | 0.5 | 109 | 27.1 | 402 |
>200000 | 107 | 16.0 | 110 | 16.4 | 41 | 6.1 | 256 | 38.2 | 6 | 0.9 | 150 | 22.4 | 670 |
. | 15 | 13.7 | 18 | 16.5 | 4 | 3.7 | 40 | 36.6 | 1 | 1.2 | 31 | 28.4 | 109 |
P value | <0.0001 | 0.9308 | 0.0891 | 0.1108 | (0.6023) | <0.0001 | |||||||
Number of deaths certified in the past 3 months | |||||||||||||
0 | 34 | 16.8 | 40 | 19.5 | 10 | 4.9 | 57 | 27.8 | 2 | 1.1 | 61 | 29.8 | 205 |
1--2 | 123 | 15.0 | 144 | 17.6 | 24 | 2.9 | 241 | 29.4 | 10 | 1.2 | 277 | 33.8 | 819 |
3--4 | 169 | 16.0 | 199 | 18.8 | 62 | 5.9 | 337 | 31.9 | 9 | 0.9 | 280 | 26.5 | 1056 |
5--9 | 149 | 15.2 | 156 | 15.8 | 50 | 5.1 | 354 | 35.9 | 8 | 0.8 | 269 | 27.3 | 986 |
10--19 | 60 | 11.6 | 100 | 19.3 | 34 | 6.6 | 202 | 39.1 | 5 | 1.0 | 116 | 22.4 | 517 |
20+ | 18 | 8.5 | 28 | 13.2 | 15 | 7.1 | 94 | 44.3 | 0 | 0.0 | 57 | 26.9 | 212 |
. | 22 | 17.5 | 21 | 16.5 | 5 | 3.9 | 39 | 30.6 | 3 | 2.4 | 37 | 29.1 | 127 |
P value | 0.0534 | 0.2641 | 0.0259 | <0.0001 | (0.4672) | 0.0006 | |||||||
In-service training on end-of-life | |||||||||||||
Yes | 197 | 10.6 | 311 | 16.7 | 101 | 5.4 | 712 | 38.3 | 10 | 0.6 | 526 | 28.3 | 1858 |
No | 370 | 18.7 | 364 | 18.3 | 94 | 4.7 | 588 | 29.6 | 25 | 1.2 | 543 | 27.4 | 1984 |
. | 8 | 10.0 | 13 | 15.5 | 5 | 5.9 | 26 | 30.9 | 3 | 3.1 | 29 | 34.5 | 84 |