ADVANCE DIRECTIVES AND OTHER MEDICAL DECISIONS CONCERNING THE END OF LIFE IN CANCER-PATIENTS IN JAPAN

The purpose of our survey was to investigate the experience of physici ans regarding advance directives and other medical decisions concernin g the end of life. A postal questionnaire was sent to 500 Japanese phy sicians who were most involved in medical care of terminal patients. A total of 339 (68%) physicians responded. In dealing with terminal pat ients, approximately half gave priority to their patients' wishes for medical care, if known, regardless of the patient's competency. Of the respondents, 149 had been presented with advance-directives by their patients and 35% followed all advance directives presented in their pr actice. Cardiopulmonary resuscitation (CPR) far arrested patients to e nable their family to be at the bedside at the time of the death was c ommon. More than 60% of the respondents thought that active euthanasia and assisted suicide were never ethically justified. Our study indica tes that the wishes of patients are currently not always given top pri ority in medical decisions concerning the end of life. (C) 1998 Elsevi er Science Ltd. All rights reserved.