• Adriaan Visser, Anna F van Leeuwen, Elsbeth Voogt, Agnes van der Heide, and Karin van der Rijt.
• Helen Dowling Institute, P.O. Box 85061, 3508 AB, Utrecht, The Netherlands. a.visser@hdi.nl
• Patient Educ Couns. 2003 Jul 1;50(3):263-4.

AbstractInformation about medical decision-making in the last stage of life and the wishes of terminally ill patients is scarce. At two hospital departments, we observed 16 multidisciplinary meetings and recorded 110 discussions concerning 74 patients. Thirty-three of these discussions concerned either starting or forgoing potentially life-prolonging therapy or applying potentially life-shortening medical interventions. The wishes of the patients were considered in 15 of these discussions. In 6 of these 15 discussions, the patient's wish was unknown. In five discussions the decision was postponed to enable discussions with the patients. Potentially life-shortening decisions were never made if patients were known to disagree. No decisions about physician-assisted death were made. The study shows that medical end-of-life decisions are commonly shared between the involved caregivers and the patients.

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