Frequency of decisions to forgo (artificial) administration of food and fluids at life's end
Van der Heide, A.; Muller, M.T.; Kester, J.G.; Groenewoud, J.H.; van der Wal, G.; van der Maas, P.J.
Nederlands Tijdschrift Voor Geneeskunde 141(40): 1918-1924
1997
ISSN/ISBN: 0028-2162 PMID: 9550738 Document Number: 473261
To determine the frequency and characteristics of decisions to forgo (artificial) feeding and hydration with hastening of death as a possible result. Retrospective, descriptive study. The Netherlands. Data were collected from questionnaires mailed to physicians attending 6060 deaths identified from death certificates dating from August through November 1995 (response rate: 77%). Decisions to forgo feeding and hydration preceded 8% of all deaths studied; for deaths attended by nursing home physicians this percentage was 23%, for deaths attended by general practitioners and specialists it was 4%. In 68% of all these death cases, the patients had been 80 years of age or over, and 76% of them had been partly or completely incompetent. The non-treatment decision had been discussed with relatives in 82% of all cases, and in 89% of the death cases attended by nursing home physicians. These patients had had (possibly) life-shortening medication less frequently than other patients for whom a medical decision concerning the end of life had been made. Decisions to forgo (artificial) feeding and hydration were made relatively often by nursing home physicians, and rarely by general practitioners and specialists. These decisions were usually but not always made after discussion with relatives. There were no indications that these decisions entailed a great deal of suffering for the patients.