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dc.creatorBosshard, Georgen
dc.creatorNilstun, Toreen
dc.creatorBilsen, Johanen
dc.creatorNorup, Michaelen
dc.creatorMiccinesi, Guidoen
dc.creatorvan Delden, Johannes J.M.en
dc.creatorFaisst, Karinen
dc.creatorvan der Heide, Agnesen
dc.date.accessioned2016-01-08T23:45:54Zen
dc.date.available2016-01-08T23:45:54Zen
dc.date.created2005-02-28en
dc.date.issued2005-02-28en
dc.identifierdoi:10.1001/archinte.165.4.401en
dc.identifier.bibliographicCitationArchives of Internal Medicine 2005 February 28; 165(4): 401- 407en
dc.identifier.urihttp://worldcatlibraries.org/registry/gateway?version=1.0&url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&atitle=Forgoing+treatment+at+the+end+of+life+in+6+European+countries&title=Archives+of+Internal+Medicine+&volume=165&issue=4&spage=407&date=2005-02&au=Bosshard,+Georg;+Nilstun,+Tore;+Bilsen,+Johan;+Norup,+Michael;+Miccinesi,+Guido;+van+Delden,+Johannes+J.M.;+Faisst,+Karin;+van+der+Heide,+Agnesen
dc.identifier.urihttp://dx.doi.org/10.1001/archinte.165.4.401en
dc.identifier.urihttp://hdl.handle.net/10822/983392en
dc.description.abstractBACKGROUND: Modern medicine provides unprecedented opportunities in diagnostics and treatment. However, in some situations at the end of a patient's life, many physicians refrain from using all possible measures to prolong life. We studied the incidence of different types of treatment withheld or withdrawn in 6 European countries and analyzed the main background characteristics. METHODS: Between June 2001 and February 2002, samples were obtained from deaths reported to registries in Belgium, Denmark, Italy, the Netherlands, Sweden, and Switzerland. The reporting physician was then sent a questionnaire about the medical decision-making process that preceded the patient's death. RESULTS: The incidence of nontreatment decisions, whether or not combined with other end-of-life decisions, varied widely from 6% of all deaths studied in Italy to 41% in Switzerland. Most frequently forgone in every country were hydration or nutrition and medication, together representing between 62% (Belgium) and 71% (Italy) of all treatments withheld or withdrawn. Forgoing treatment estimated to prolong life for more than 1 month was more common in the Netherlands (10%), Belgium (9%), and Switzerland (8%) than in Denmark (5%), Italy (3%), and Sweden (2%). Relevant determinants of treatment being withheld rather than withdrawn were older age (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.31-1.79), death outside the hospital (death in hospital: OR, 0.80; 95% CI, 0.68- 0.93), and greater life-shortening effect (OR, 1.75; 95% CI, 1.27- 2.39). CONCLUSIONS: In all of the participating countries, life- prolonging treatment is withheld or withdrawn at the end of life. Frequencies vary greatly among countries. Low-technology interventions, such as medication or hydration or nutrition, are most frequently forgone. In older patients and outside the hospital, physicians prefer not to initiate life-prolonging treatment at all rather than stop it later.en
dc.formatArticleen
dc.languageenen
dc.sourceeweb:282535en
dc.subjectDeathen
dc.subjectLifeen
dc.subjectMedicineen
dc.subjectMethodsen
dc.subjectNutritionen
dc.subjectPatientsen
dc.subjectPhysiciansen
dc.subjectRegistriesen
dc.subjectReportingen
dc.subjectTechnologyen
dc.subject.classificationInternational and Political Dimensions of Biology and Medicineen
dc.subject.classificationProlongation of Life and Euthanasiaen
dc.titleForgoing Treatment at the End of Life in 6 European Countriesen
dc.provenanceCitation prepared by the Library and Information Services group of the Kennedy Institute of Ethics, Georgetown University for the ETHXWeb database.en
dc.provenanceCitation migrated from OpenText LiveLink Discovery Server database named EWEB hosted by the Bioethics Research Library to the DSpace collection EthxWeb hosted by DigitalGeorgetown.en


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