Do internists know what limitation of therapeutic effort means

Abstract Objectives To ascertain whether internists know what limitation of therapeutic effort (LTE) means and whether training in palliative care affects this understanding. Methods A survey was administered to Spanish internists on their knowledge of LTE and training in palliative care. Results A total of 273 respondents completed the survey (mean age, 42 ± 12 years), 80.2% of whom were associates. Some 23.8% of the respondents identified the complete definition of LTE. The most frequently selected responses were “not starting an active treatment” (85.0%) and “withdrawing an active treatment” (65.9%). Forty-three percent of the respondents lacked training in palliative care, 73.3% considered their level of understanding to be good or very good, 62.3% stated that they became anxious when addressing planning for end-of-life care with a patient, and 81.3% stated that they had experienced some conflict with their LTE decisions. Conclusions Only 1 of every 4 internists knew the proper definition of LTE, with no association with the level of training in palliative care.