Table 4 Characteristics of decision-making by type of medical decision (non sudden deaths)
Life prolonging treatment | Withholding treatment | Withdrawing treatment | Intensification of alleviation of symptoms | Administration of a medication to deliberately hasten death | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | n | % | |
Decision discussed with patient (by respondent or other physician) | ||||||||||
Yes | 55 | 9.6 | 40 | 8.02 | 12 | 8.63 | 263 | 19.82 | 6 | 16.18 |
No | 79 | 13.7 | 40 | 8.02 | 3 | 2.16 | 44 | 3.32 | 2 | 6.31 |
Patient not competent | 308 | 53.6 | 357 | 71.54 | 112 | 80.55 | 904 | 68.12 | 25 | 67.40 |
Don't know | 19 | 3.3 | 6 | 1.20 | 3 | 2.19 | 26 | 1.96 | 1 | 3.46 |
No response | 114 | 19.8 | 56 | 11.22 | 9 | 6.47 | 90 | 6.78 | 2 | 6.65 |
Discussion, per 100 competent patients | 41.0 | 50.0 | 80.0 | 85.7 | 71.9 | |||||
Decision following patient's explicit request | ||||||||||
Yes and request repeated | 14 | 2.43 | 20 | 4.03 | 9 | 6.39 | 166 | 12.50 | 8 | 21.00 |
Yes and request not repeated | 4 | 0.69 | 5 | 1.01 | 1 | 0.62 | 41 | 3.09 | 2 | 5.85 |
Yes and do not know whether request repeated | 7 | 1.22 | 7 | 1.41 | 0 | 0.00 | 40 | 3.01 | 1 | 2.63 |
No | 418 | 72.57 | 392 | 79.03 | 117 | 83.06 | 962 | 72.44 | 22 | 58.92 |
No response | 133 | 23.09 | 72 | 14.52 | 14 | 9.94 | 119 | 8.96 | 4 | 11.60 |
Patient expressed wish at some moment to hasten death | ||||||||||
Yes | 13 | 2.26 | 46 | 9.26 | 14 | 10.00 | 203 | 15.31 | 14 | 38.35 |
No | 333 | 57.81 | 261 | 52.52 | 86 | 61.43 | 809 | 61.01 | 11 | 28.99 |
Do not know | 115 | 19.97 | 126 | 25.35 | 30 | 21.43 | 210 | 15.84 | 10 | 27.30 |
No response | 115 | 19.97 | 64 | 12.88 | 10 | 7.14 | 104 | 7.84 | 2 | 5.36 |
Decision discussed with another person | ||||||||||
incompetent person | ||||||||||
Doctors | 102 | 33.12 | 136 | 38.10 | 62 | 55.36 | 434 | 48.01 | 14 | 56.00 |
Nurses and nursing assistants, medical care team | 49 | 15.91 | 95 | 26.61 | 42 | 37.50 | 326 | 36.06 | 10 | 40.00 |
Family | 74 | 24.03 | 171 | 47.90 | 64 | 57.14 | 549 | 60.73 | 19 | 76.00 |
Other people | 1 | 0.32 | 3 | 0.84 | 0 | 0.00 | 4 | 0.44 | 0 | 0.00 |
Trusted third party | 19 | 6.17 | 29 | 8.12 | 15 | 13.39 | 150 | 16.59 | 5 | 20.00 |
As part of a collective decision | 16 | 5.19 | 24 | 6.72 | 15 | 13.39 | 137 | 15.15 | 5 | 20.00 |
No | 119 | 38.64 | 48 | 13.45 | 4 | 3.57 | 57 | 6.31 | 1 | 4.00 |
No response | 7 | 2.27 | 8 | 2.24 | 1 | 0.89 | 11 | 1.22 | 0 | 0.00 |
Trusted third party | ||||||||||
incompetent person | ||||||||||
Yes and involved in discussion phase | 57 | 18.51 | 71 | 19.89 | 22 | 19.64 | 312 | 34.55 | 8 | 32.00 |
Yes and not involved in discussion phase | 19 | 6.17 | 7 | 1.96 | 6 | 5.36 | 11 | 1.22 | 1 | 4.00 |
Yes and do not know whether involved or not | 4 | 1.30 | 2 | 0.56 | 1 | 0.89 | 3 | 0.33 | 0 | 0.00 |
No | 99 | 32.14 | 108 | 30.25 | 31 | 27.68 | 295 | 32.67 | 10 | 40.00 |
No because patient not capable of naming one | 54 | 17.53 | 105 | 29.41 | 27 | 24.11 | 177 | 19.60 | 4 | 16.00 |
Do not know | 75 | 24.35 | 64 | 17.93 | 25 | 22.32 | 105 | 11.63 | 2 | 8.00 |
Advance directive | ||||||||||
incompetent person | ||||||||||
Yes and was an important factor in the decision | 1 | 0.32 | 2 | 0.56 | 0 | 0.00 | 9 | 1.00 | 2 | 8.00 |
Yes and was not important factor in the decision | 0 | 0.00 | 2 | 0.56 | 0 | 0.00 | 3 | 0.33 | 0 | 0.00 |
Yes and do not know whether important factor in the decision | 0 | 0.00 | 0 | 0.00 | 0 | 0.00 | 0 | 0.00 | 0 | 0.00 |
No | 185 | 60.06 | 233 | 65.45 | 75 | 66.96 | 685 | 75.86 | 16 | 64.00 |
Do not know | 122 | 39.61 | 119 | 33.43 | 37 | 33.04 | 206 | 22.81 | 7 | 28.00 |
Best description of the medical act | ||||||||||
Symptom treatment | 337 | 58.41 | 144 | 28.92 | 17 | 12.15 | 717 | 54.03 | 7 | 19.44 |
Decision to withhold or withdraw treatment | 20 | 3.47 | 237 | 47.59 | 104 | 74.31 | 123 | 9.27 | 6 | 17.06 |
Sedation for distress in terminal phase | 10 | 1.73 | 19 | 3.82 | 1 | 0.60 | 361 | 27.21 | 17 | 45.59 |
Euthanasia | 0 | 0.00 | 0 | 0.00 | 1 | 0.79 | 1 | 0.07 | 5 | 12.04 |
Medically assisted suicide | 0 | 0.00 | 0 | 0.00 | 0 | 0.00 | 0 | 0.00 | 0 | 0.00 |
Other | 66 | 11.44 | 30 | 6.02 | 6 | 4.29 | 18 | 1.36 | 0 | 0.00 |
No response | 144 | 24.96 | 68 | 13.65 | 11 | 7.86 | 107 | 8.06 | 2 | 5.87 |