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 |
All percentages are weighted for non-response, to ensure there are representative of the initial. The percentage cannot be derived from the absolute unweighted absolute numbers.