title: [Ethical decision-making at the end of life--knowledge and attitudes of medical students].
abstract: OBJECTIVE
  Physicians are often confronted with ethical and legal questions at the end of life. In this study we asked medical students at the universities of Mainz and Berlin (Charité) about the "Guidelines on Physicians' Aid to the Dying" issued by the German Medical Association: their moral attitude and legal knowledge regarding the limitation of medical procedures at the end of life and their judgement about the quality of medical education on these topics.
  
  
  METHODS
  569 medical students in their 1. and 4. clinical semester as well as the final year of their studies in Mainz and students in their 5. year of studies in Berlin received a questionnaire containing 14 items relating to ethical and legal questions at the end of life.
  
  
  RESULTS
  308 (54.1%) completed the questionnaire. 7.8% knew the contents of the "Guidelines on Physicians' Aid to the Dying". Between 10% (use of catecholamines) and 62% (parenteral feeding) viewed withholding or withdrawing life-sustaining measures from dying patients as illegal. 39-72% held the view that measures of nutrition and hydration were part of the indispensable basic medical care for every patient. 12-26% were unsure with respect to their moral views about withholding and withdrawal of therapy. 82% felt insufficiently prepared for dealing with ethical questions at the end of life.
  
  
  CONCLUSIONS
  Only a minority of medical students was informed about ethical principles and legal regulations regarding end-of-life decisions. Teaching of ethical and legal knowledge and integration of these issues into clinical problem solving should be mandatory.
authors.affiliation: III. Medizinische Klinik und Institut für Medizinische Biometrie, Epidemiologie und Informatik, Universitätskliniken Mainz, und Institut für Rechtsmedizin der Johannes Gutenberg-Universität Mainz. drweber@hospiz-mainz.de
authors.forename: M
authors.initials: M
authors.lastname: Weber
authors.forename: J
authors.initials: J
authors.lastname: Schildmann
authors.forename: J
authors.initials: J
authors.lastname: Schüz
authors.forename: E
authors.initials: E
authors.lastname: Herrmann
authors.forename: J
authors.initials: J
authors.lastname: Vollmann
authors.forename: C
authors.initials: C
authors.lastname: Rittner
mesh_terms: D016223:Advance Directives / Q000941:ethics / Q000331:legislation & jurisprudence; D003657:Decision Making / Q000941:ethics*; D004504:Education, Medical, Undergraduate / Q000592:standards*; D005260:Female; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008020:Life Support Care / Q000941:ethics / Q000331:legislation & jurisprudence / Q000592:standards; D008297:Male; D010358:Patient Participation; D017410:Practice Guidelines as Topic; D011379:Prognosis; D013337:Students, Medical / Q000523:psychology; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000941:ethics* / Q000331:legislation & jurisprudence / Q000592:standards; D028761:Withholding Treatment / Q000941:ethics / Q000331:legislation & jurisprudence