Treatment Decisions at the End of Life: Results of a Cross-Sectional Study Among Physician Members of the German Association for Palliative Medicine

INTRODUCTION In Germany there is comparably scarce data on ethical and clinical aspects of physicians practice at the end of life. In this paper we summarise selected results of a survey among physician members of the German Association for Palliative Medicine. METHODS Cross-sectional postal survey among physician members of the German Association for Palliative Medicine using the EURELD (European end-of-life decisions)-survey instrument. RESULTS 901 physicians participated in the study (response rate = 55.8 %). There was alleviation of symptoms in 78.1 % and limitation of medical treatment with possible life shortening in 69.1 % of eligible cases. In 10 cases medication had been administered by the physician (n = 9) or the patient (n = 1) with the intention to hasten death. In 22 cases physicians indicated that they had not involved competence patients because of the „best interest” of the patient (n = 11) and because of avoidance of possible harm for the patient (n = 11). Physicians with added qualification in palliative medicine performed significantly more often treatment of symptoms with possible shortening of life than physicians without this qualification (p < 0.001). DISCUSSION Physician members of the German Association for Palliative Medicine perform a broad spectrum of end-of-life practices. The data on physicians' practice can provide stimulus to the debate about an appropriate normative and practical framework for end-of-life decision making.