Swiss doctors' attitudes towards end-of-life decisions and their determinants: a comparison of three language regions.
OBJECTIVE
To investigate attitudes to end-of-life decisions, and the influence of cultural factors and of doctors' personal characteristics on these attitudes.


METHODS
As part of a European research project (EURELD), a study on attitudes towards medical end-of-life decisions was conducted among doctors in the German-, French- and Italian-speaking areas of Switzerland. A written questionnaire was sent to a random sample of nine different types of specialist; it presented 14 statements on end-of-life decisions and doctors were asked whether they agreed or disagreed with them.


RESULTS
The response rate was 64%. 1360 questionnaires were studied. The results show general agreement with statements on the alleviation of pain and other symptoms with possible life-shortening effect, as well as on non-treatment decisions. The language region was a strong determinant of agreement on some attitudes towards end-of-life decisions. Agreement on the use of lethal drugs and alleviation of pain and other symptoms with possible life-shortening effect was higher among French-speaking than among German- and Italian-speaking doctors. For nontreatment decisions, agreement was higher in the German-speaking region than in the French- and Italian-speaking regions of the country. Italian-speaking doctors were strongly opposed to any kind of end-of-life decision. Religious believers and those who attended a larger number of terminal patients tended to disagree more often with end-of-life decisions than the other doctors.


CONCLUSIONS
In end-of-life decision-making, Switzerland represents "Europe in miniature". The impact on end-of-life decisions of cultural factors and the number of terminal patients attended needs further consideration.
Fischer
Susanne
S
University of Zurich, Institute of Sociology, Zurich, Switzerland. susanne.fischer@soziologie.unizh.ch
Bosshard
Georg
G
Faisst
Karin
K
Tschopp
Alois
A
Fischer
Johannes
J
Bär
Walter
W
Gutzwiller
Felix
F
D000328:Adult; D001291:Attitude of Health Personnel; D003657:Decision Making; D005260:Female; D005843:Geography; D019538:Health Care Surveys; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010820:Physicians / Q000523:psychology*; D011365:Professional Practice Location; D012068:Religion and Medicine; D011795:Surveys and Questionnaires; D013557:Switzerland; D013727:Terminal Care