title: [Attitudes towards patient care at the end of life. A survey of directors of neurological departments].
abstract: In view of the increasing importance of palliative medicine and end-of-life care of neurological patients, a survey from the American Academy of Neurology was translated in a validated fashion and sent to all medical directors of neurological departments in Germany. The topics of the survey comprised-based on clinical scenarios-the withdrawal or withholding of life-sustaining measures, physician-assisted suicide (PAS) and euthanasia, advance directives and health care proxies, principles of palliative care, and ethical and legal questions in end-of-life care. Of 411 directors of departments, 152 participated in the survey. Almost all respondents support a patient's right to refuse life-sustaining treatment. Thirty-two percent think it is illegal to administer analgesics in doses that risk respiratory depression. Forty-five percent believe that treating terminal dyspnea with morphine is the same as euthanasia. Despite the fact that 88% of the respondents regard advance directives as helpful, only an average of 4% of their patients have completed one. About one third of the respondents have been confronted with a request by patients for PAS or euthanasia. Thirty-five percent believe that PAS should be made explicitly legal for terminally ill patients. Forty-six percent of the respondents believe that their training in end-of-life care was insufficient, and 91% express interest in education programs on palliative care.
authors.affiliation: Interdisziplinäres Zentrum für Palliativmedizin und Neurologische Klinik, Ludwig-Maximilians-Universität München, München. Borasio@med.uni-muenchen.de
authors.forename: G D
authors.initials: GD
authors.lastname: Borasio
authors.forename: B
authors.initials: B
authors.lastname: Weltermann
authors.forename: R
authors.initials: R
authors.lastname: Voltz
authors.forename: H
authors.initials: H
authors.lastname: Reichmann
authors.forename: S
authors.initials: S
authors.lastname: Zierz
mesh_terms: D001291:Attitude of Health Personnel; D001293:Attitude to Death; D003625:Data Collection; D005858:Germany / Q000453:epidemiology; D006748:Hospital Departments / Q000706:statistics & numerical data*; D007857:Leadership; D009462:Neurology / Q000706:statistics & numerical data*; D013727:Terminal Care / Q000706:statistics & numerical data*; D019452:Terminally Ill / Q000706:statistics & numerical data*