title: Labelling of end-of-life decisions by physicians.
abstract: OBJECTIVE
  Potentially life-shortening medical end-of-life practices (end-of-life decisions (ELDs)) remain subject to conceptual vagueness. This study evaluates how physicians label these practices by examining which of their own practices (described according to the precise act, the intention, the presence of an explicit patient request and the self-estimated degree of life shortening)they label as euthanasia or sedation.
  
  
  METHODS
  We conducted a large stratified random sample of death certificates from 2007 (N=6927).The physicians named on the death certificate were approached by means of a postal questionnaire asking about ELDs made in each case and asked to choose the most appropriate label to describe the ELD. Response rate was 58.4%.
  
  
  RESULTS
  In the vast majority of practices labelled as euthanasia, the self-reported actions of the physicians corresponded with the definition in the Belgian euthanasia legislation; practices labelled as palliative or terminal sedation lack clear correspondence with definitions of sedation as presented in existing guidelines. In these cases, an explicit life-shortening intention by means of drug administration was present in 21.6%, life shortening was estimated at more than 24 h in 51% and an explicit patient request was absentin 79.7%.
  
  
  CONCLUSIONS
  Our results suggest that, unlike euthanasia,the concept of palliative or terminal sedation covers abroad range of practices in the minds of physicians. This ambiguity can be a barrier to appropriate sedation practice and indicates a need for better knowledge of the practice of palliative sedation by physicians.
authors.forename: Jef
authors.initials: J
authors.lastname: Deyaert
authors.forename: Kenneth
authors.initials: K
authors.lastname: Chambaere
authors.forename: Joachim
authors.initials: J
authors.lastname: Cohen
authors.forename: Marc
authors.initials: M
authors.lastname: Roelands
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
mesh_terms: D001291:Attitude of Health Personnel; D004992:Ethics, Medical; D005065:Euthanasia; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D033182:Intention; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D013727:Terminal Care / Q000379:methods*; D009626:Terminology as Topic
chemical_list: D006993:Hypnotics and Sedatives