End-of-life decisions of physicians in the city of Hasselt (Flanders, Belgium)

Objectives: The objective of this study is to estimate the proportion of di fferent types of end-of-life decisions (ELDs) of physicians in the city of Hasselt (Flanders, Belgium), The question is addressed to what degree these ELD meet legal constraints and the ethical requirements for prudent practi ce. Methodology: All physicians of the city of Hasselt who signed at least one death certificate in 1996 (N = 166) received an anonymous self-administered mail questionnaire per death case (max. 5/doctor). Results: the response rate was 55% (N = 269). rn 37.3% of all cases at leas t one ELD was made (16.5% non-treatment decisions; 16% potential life-short ening by intensifying the treatment of pain and symptoms; 4.8% administrati on, supply or prescription of lethal drugs). In 59.5% of the cases were an ELD was made that decision was legally questionable. Patient characteristic s were clearly related to the type of ELD There was no influence of physici an characteristics, except for commitment to life-stance, In 71.3 % of the cases the ELD was in no way discussed with the patient, 8.1 % of the ELD-ca ses were in response to a direct request from the patient. Conclusions: The incidences of ELDs in Hasselt are consistent with earlier findings. The study shows that religious commitment influences the behaviou r of physicians at the end of their patients' life. The patient's and her f amily's entitlements to participation in the decision making process were r ather poorly respected.