José António Ferraz Gonçalves1. 1. Instituto Português de Oncologia, UCP-R, Rua Dr. António Bernardino de Almeida, Porto, Portugal. ferrazg@ipoporto.min-saude.pt
Abstract
BACKGROUND: The aim of this study was to determine the attitude of Portuguese oncologists toward end-of-life situations other than euthanasia and assisted suicide. METHODS: This study used a survey of 450 Portuguese oncologists by postal means and personal contact. MAIN RESULTS: The response rate was 33% (143). Only 7.7% doctors would give lethal doses of drugs to someone with an incurable, advanced, and progressive disease that is unable to make decisions, at the request of a family member or other close person. However, 30 doctors (21.3%) would prefer, in the event they were in such a situation, that the drugs be given them at their request. None of the 12.4% who have received such requests admitted to committing any of those acts. Almost 70% of the doctors would withdraw life support measures at the patient's request if the same had an incurable, advanced, and progressive disease, and a further 14% would do it in certain circumstances, but only 41% would withdraw measures such as nutrition and hydration. Fewer doctors would withdraw such measures including nutrition and hydration at a family member's request or on their own initiative. Religion has a major influence on the doctors' opinion. Most doctors (96.5%) agreed with the administration of drugs for symptom control even foreseeing that they could shorten life. CONCLUSION: Most Portuguese oncologists respect patients' autonomy, favoring the withdrawal of life support treatment at the patients' request when appropriate and much less do so on the request of others or by their own initiative. They appropriately do not confuse those practices with symptom relief even when hastened death can be envisaged.
BACKGROUND: The aim of this study was to determine the attitude of Portuguese oncologists toward end-of-life situations other than euthanasia and assisted suicide. METHODS: This study used a survey of 450 Portuguese oncologists by postal means and personal contact. MAIN RESULTS: The response rate was 33% (143). Only 7.7% doctors would give lethal doses of drugs to someone with an incurable, advanced, and progressive disease that is unable to make decisions, at the request of a family member or other close person. However, 30 doctors (21.3%) would prefer, in the event they were in such a situation, that the drugs be given them at their request. None of the 12.4% who have received such requests admitted to committing any of those acts. Almost 70% of the doctors would withdraw life support measures at the patient's request if the same had an incurable, advanced, and progressive disease, and a further 14% would do it in certain circumstances, but only 41% would withdraw measures such as nutrition and hydration. Fewer doctors would withdraw such measures including nutrition and hydration at a family member's request or on their own initiative. Religion has a major influence on the doctors' opinion. Most doctors (96.5%) agreed with the administration of drugs for symptom control even foreseeing that they could shorten life. CONCLUSION: Most Portuguese oncologists respect patients' autonomy, favoring the withdrawal of life support treatment at the patients' request when appropriate and much less do so on the request of others or by their own initiative. They appropriately do not confuse those practices with symptom relief even when hastened death can be envisaged.
Authors: Johan Bilsen; Michael Norup; Luc Deliens; Guido Miccinesi; Gerrit van der Wal; Rurik Löfmark; Karin Faisst; Agnes van der Heide Journal: J Pain Symptom Manage Date: 2006-02 Impact factor: 3.612
Authors: Agnes van der Heide; Luc Deliens; Karin Faisst; Tore Nilstun; Michael Norup; Eugenio Paci; Gerrit van der Wal; Paul J van der Maas Journal: Lancet Date: 2003-08-02 Impact factor: 79.321