Patients and doctors are often involved in medical decisions during terminal care, according to a new study.

When someone has a terminal illness there are many issues to consider. For instance, should life-prolonging treatment, such as ventilation, be refused at some point? Or, even, should large doses of painkillers that would hasten death be an option?

Researchers at Erasmus University, Rotterdam, The Netherlands, looked at the role such medical decisions played in the care of over 20,000 patients with terminal illness in Belgium, Denmark, Italy, The Netherlands, Sweden and Switzerland. In about one third of cases, death came suddenly or unexpectedly so that end-of-life decisions were not common.

In most other cases, medical decisions were common, doctors said. The researchers found that 23 per cent of terminal cases in Italy involved such decisions, and they arose in half of such cases in Switzerland. When it came to administration of drugs that could hasten death, this occurred among one per cent or less of terminal cases in Denmark, Italy, Sweden and Switzerland, 1.82 per cent in Belgium and 3.4 per cent in The Netherlands. Further research in this area may lead to new ways of enhancing the care of the terminally ill.

Source

The Lancet 2nd August 2003