Physicians’ attitudes towards end-of-life decisions: a comparison between seven countries

Guido Miccinesi, Center for Study and Prevention of Cancer, Florence
Susanne Fischer, University of Zurich
E Paci, Center for Study and Prevention of Cancer, Florence
Bregje D. Onwuteaka-Philipsen, Vrije University
Colleen M. Cartwright, Southern Cross University
Agnes van der Heide, University Medical Center, Rotterdam
Tore Nilstun, Lund University
Michael Norup, Institute of Public Health University, Copenhagen
Freddy Mortier, Ghent University

Abstract

In the context of an European collaborative research project (EURELD), a study on attitudes towards medical end-of-life decisions was conducted among physicians in Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. Australia also joined the consortium. A written questionnaire with structured questions was sent to practising physicians from specialties frequently involved in the care of dying patients. 10,139 questionnaires were studied. Response rate was equal to or larger than 50% in all countries except Italy (39%). Apart from general agreement with respect to the alleviation of pain and symptoms with possible life-shortening effect, there was large variation in support—between and within countries—for medical decision that may result in the hastening of death. A principal component factor analysis found that 58% of the variance of the responses is explained by four factors. ‘Country’ explained the largest part of the variation of the standardized factor scores.