title: End-of-life practices in palliative care: a cross sectional survey of physician members of the German Society for Palliative Medicine.
abstract: OBJECTIVE
  To elicit types and frequencies of end-of-life practices by physician members of the German Society for Palliative Medicine. To analyse associations between characteristics of physicians and patients and end-of-life practices with intended hastening of death.
  
  
  METHODS
  Cross-sectional postal survey.
  
  
  METHODS
  Types and frequencies of end-of-life practices with foreseeable or intended hastening of patients' death. Association between end-of-life practices with hastening of death and predefined characteristics of physicians and patients.
  
  
  RESULTS
  Nine hundred and one physicians participated in the study (response rate: 55.8%). There was alleviation of symptoms in 78.1% and limitation of medical treatment with possible life shortening in 69.1% of cases. In 10 cases medication had been administered by the physician (N = 9) or the patient (N = 1) with the intention to hasten death. Patients' best interest and avoidance of possible harm to the patient were reported as reasons for non-involvement of competent patients in decision making. Physicians with added qualification in palliative medicine significantly less frequently reported end-of-life practices with intended hastening of death (p = 0.003).
  
  
  CONCLUSIONS
  Physician members of the German Society for Palliative Medicine perform a broad spectrum of end-of-life practices including intended hastening of death. The findings on patients' non-involvement in decision making warrant further empirical-ethical analysis.
authors.affiliation: Institute for Medical Ethics and History of Medicine, Ruhr-University Bochum, Malakowturm-Markstr. 258a, 44799 Bochum, Germany. jan.schildmann@rub.de
authors.forename: Jan
authors.initials: J
authors.lastname: Schildmann
authors.forename: Julia
authors.initials: J
authors.lastname: Hoetzel
authors.forename: Christof
authors.initials: C
authors.lastname: Mueller-Busch
authors.forename: Jochen
authors.initials: J
authors.lastname: Vollmann
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D004812:Epidemiologic Methods; D028601:Euthanasia, Active / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods* / Q000523:psychology; D011364:Professional Practice / Q000706:statistics & numerical data; D017678:Sex Distribution; D055815:Young Adult