BACKGROUND AND OBJECTIVE: Assuming the hypothesis that the general practitioner (GP) can and should be a key player in making end-of-life decisions for hospitalised patients, perceptions of GPs' role assigned to them by hospital doctors in making withdrawal decisions for such patients were surveyed. DESIGN: Questionnaire survey. SETTING: Urban (districts located near Paris) and rural (southern France) areas. PARTICIPANTS: GPs. RESULTS: The response rate was 32.2% (161/500), and it was observed that 70.8% of respondents believed that their participation in withdrawal decisions for their hospitalised patients was essential, whereas 42.1% believed that the hospital doctors were sufficiently skilled to make withdrawal decisions without input from the GPs. Most respondents were found to believe that they had the necessary skills (91.9%) and enough time (87.6%) to participate in withdrawal decisions. The last case of treatment withdrawal in hospital for one of their patients was described by 40% (65/161) of respondents, of whom only 40.0% (26/65) believed that they had participated actively in the decision process. The major factors in the multivariate analysis were the GP's strong belief that his or her participation was essential (p = 0.01), information on admission of the patient given to the GP by the hospital department (p = 0.007), rural practice (p = 0.03), visit to the patient dying in hospital (p = 0.02) and a request by the family to be kept informed about the patient (p = 0.003). CONCLUSION: Strong interest was evinced among GPs regarding end-of-life issues, as well as considerable experience of patients dying at home. As GPs are more closely corrected to patients' families, they may be a good choice for third-party intervention in making end-of-life decisions for hospitalised patients.
BACKGROUND AND OBJECTIVE: Assuming the hypothesis that the general practitioner (GP) can and should be a key player in making end-of-life decisions for hospitalised patients, perceptions of GPs' role assigned to them by hospital doctors in making withdrawal decisions for such patients were surveyed. DESIGN: Questionnaire survey. SETTING: Urban (districts located near Paris) and rural (southern France) areas. PARTICIPANTS: GPs. RESULTS: The response rate was 32.2% (161/500), and it was observed that 70.8% of respondents believed that their participation in withdrawal decisions for their hospitalised patients was essential, whereas 42.1% believed that the hospital doctors were sufficiently skilled to make withdrawal decisions without input from the GPs. Most respondents were found to believe that they had the necessary skills (91.9%) and enough time (87.6%) to participate in withdrawal decisions. The last case of treatment withdrawal in hospital for one of their patients was described by 40% (65/161) of respondents, of whom only 40.0% (26/65) believed that they had participated actively in the decision process. The major factors in the multivariate analysis were the GP's strong belief that his or her participation was essential (p = 0.01), information on admission of the patient given to the GP by the hospital department (p = 0.007), rural practice (p = 0.03), visit to the patient dying in hospital (p = 0.02) and a request by the family to be kept informed about the patient (p = 0.003). CONCLUSION: Strong interest was evinced among GPs regarding end-of-life issues, as well as considerable experience of patients dying at home. As GPs are more closely corrected to patients' families, they may be a good choice for third-party intervention in making end-of-life decisions for hospitalised patients.
Authors: Edouard Ferrand; François Lemaire; Bernard Regnier; Khaldoun Kuteifan; Michel Badet; Pierre Asfar; Samir Jaber; Jean-Luc Chagnon; Anne Renault; René Robert; Frédéric Pochard; Christian Herve; Christian Brun-Buisson; Philippe Duvaldestin Journal: Am J Respir Crit Care Med Date: 2003-01-24 Impact factor: 21.405
Authors: Marc K Ben Diane; Patrick Peretti-Watel; Jean-Marc Lapiana; Roger Favre; Anne Galinier; Hervé Pegliasco; Yolande Obadia Journal: Ann Med Interne (Paris) Date: 2003-11
Authors: F Pochard; E Azoulay; S Chevret; C Vinsonneau; M Grassin; F Lemaire; C Hervé; B Schlemmer; R Zittoun; J F Dhainaut Journal: Crit Care Med Date: 2001-10 Impact factor: 7.598
Authors: Barbara Hanratty; Derek Hibbert; Frances Mair; Carl May; Christopher Ward; Simon Capewell; Andrea Litva; Ged Corcoran Journal: BMJ Date: 2002-09-14
Authors: David M Studdert; Michelle M Mello; Jeffrey P Burns; Ann Louise Puopolo; Benjamin Z Galper; Robert D Truog; Troyen A Brennan Journal: Intensive Care Med Date: 2003-07-19 Impact factor: 17.440