新西兰全科医生的临终决策：一项全国性调查。

End of life decision-making by New Zealand general practitioners: a national survey.

作者信息

Mitchell Kay, Owens Glynn

机构信息

Department of Psychology, University of Auckland, Auckland, New Zealand.

出版信息

N Z Med J. 2004 Jun 18;117(1196):U934.

PMID:15280938

Abstract

AIM

To explore type and incidence of medical decisions at the end of life that hasten death made by general practitioners in New Zealand, within the context of access to palliative care.

METHOD

An anonymous questionnaire investigating the last death attended in the previous 12 months was sent to 2602 general practitioners (GPs) in New Zealand.

RESULTS

From a 48% (1255) response, 88.9% (1116) GPs indicated access to an interdisciplinary pain management or palliative care team. Of those attending a death in the previous 12 months, 63% (693) had made a prior medical decision. These decisions included withdrawing/withholding treatment or increasing pain relief with (a) probability death would be hastened 61.8% (428) or (b) partly or explicitly to hasten death 32.6% (226). Moreover, death was caused by a drug supplied or administered by the GP in 5.6% cases (39), actions consistent with physician-assisted death.

CONCLUSION

Physician-assisted death provided by some general practitioners in New Zealand is occurring within the context of available palliative care.

摘要

目的

在可获得姑息治疗的背景下，探讨新西兰全科医生做出的加速死亡的临终医疗决策的类型和发生率。

方法

向新西兰的2602名全科医生发送了一份匿名调查问卷，调查他们在过去12个月中参与的最后一例死亡情况。

结果

在48%（1255份）的回复中，88.9%（1116名）的全科医生表示可获得跨学科疼痛管理或姑息治疗团队的服务。在过去12个月中参与过死亡病例的医生里，63%（693名）曾做出过预先医疗决策。这些决策包括停止/不给予治疗或增加止痛措施，其中（a）可能加速死亡的占61.8%（428名），（b）部分或明确为加速死亡的占32.6%（226名）。此外，在5.6%的病例（39例）中，死亡由全科医生提供或给予的药物导致，这些行为符合医生协助死亡。