title: End-of-life decisions in Australian medical practice.
abstract: OBJECTIVE
  To estimate the proportion of medical end-of-life decisions in Australia, describe the characteristics of such decisions and compare these data with medical end-of-life decisions in the Netherlands, where euthanasia is openly practised.
  
  
  METHODS
  Postal survey, conducted between May and July 1996, using a self-administered questionnaire based on the questionnaire used to determine medical end-of-life decisions in the Netherlands in 1995.
  
  
  METHODS
  A random sample of active medical practitioners from all Australian States and Territories selected from medical disciplines in which there were opportunities to be the attending doctor at non-acute patient deaths, and hence to make medical end-of-life decisions.
  
  
  METHODS
  Proportion of Australian deaths that involved a medical end-of-life decision, using ratio-to-size estimation based on the sampled doctors' responses to the questionnaire. The response rate was 64%.
  
  
  RESULTS
  The proportion of all Australian deaths that involved a medical end-of-life decision were: euthanasia, 1.8% (including physician-assisted suicide, 0.1%); ending of patient's life without patient's concurrent explicit request, 3.5%; withholding or withdrawing of potentially life-prolonging treatment, 28.6%; alleviation of pain with opioids in doses large enough that there was a probable life-shortening effect, 30.9%. In 30% of all Australian deaths, a medical end-of-life decision was made with the explicit intention of ending the patient's life, of which 4% were in response to a direct request from the patient. Overall, Australia had a higher rate of intentional ending of life without the patient's request than the Netherlands.
  
  
  CONCLUSIONS
  Australian law has not prevented doctors from practising euthanasia or making medical end-of-life decisions explicitly intended to hasten the patient's death without the patient's request.
authors.affiliation: Centre for Human Bioethics, Monash University, Clayton, VIC. helga.kuhse@arts.monash.edu.au
authors.forename: H
authors.initials: H
authors.lastname: Kuhse
authors.forename: P
authors.initials: P
authors.lastname: Singer
authors.forename: P
authors.initials: P
authors.lastname: Baume
authors.forename: M
authors.initials: M
authors.lastname: Clark
authors.forename: M
authors.initials: M
authors.lastname: Rickard
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D003657:Decision Making; D005065:Euthanasia; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D010820:Physicians / Q000523:psychology; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000706:statistics & numerical data*