title: End-of-life medical decision making in general practice in New Zealand--13 years on.
abstract: OBJECTIVE
  The aim of this study was to explore medical decision-making practices at the end-of-life made by GPs (MDEL) in New Zealand and to identify changes in practice with a previous study published in 2004.
  
  
  METHODS
  A postal questionnaire was sent to 3,420 GPs in New Zealand in May 2013. Anonymous phone interviews were also undertaken. Analysis of the questionnaire was done on IBM SPSS Statistics 21.
  
  
  RESULTS
  There was a 21% response rate from two mail outs. Of the 650 GPs who responded, 547 had contact with a patient prior to death and had the potential to make a MDEL. Of these, 359 (65.6%) reported making a MDEL. Of the 359 GPs who reported making a MDEL, 16 (4.5%) attributed death to a drug that had been prescribed, supplied or administered explicitly for the purpose of hastening the patient's death. The alleged involvement of nurses in practices that intentionally hasten death is high.
  
  
  CONCLUSIONS
  Our study shows that some GPs have explicitly assisted their patients to die, that nurses are allegedly involved, and there is a tendency towards more discussion with patients about MDEL.
authors.affiliation: Senior Lecturer in Clinical Medical Ethics, Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland. p.malpas@auckland.ac.nz.
authors.forename: Phillipa J
authors.initials: PJ
authors.lastname: Malpas
authors.affiliation: Psychological Medicine, University of Auckland.
authors.forename: Kay
authors.initials: K
authors.lastname: Mitchell
authors.affiliation: Psychological Medicine, University of Auckland.
authors.forename: Heidi
authors.initials: H
authors.lastname: Koschwanez
mesh_terms: D000328:Adult; D000368:Aged; D000066491:Clinical Decision-Making; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D059408:Pain Management; D010166:Palliative Care; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D013727:Terminal Care; D013997:Time Factors