Document Detail

Participation of French general practitioners in end-of-life decisions for their hospitalised patients.
MedLine Citation:
PMID:  17145904     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: Assuming the hypothesis that the general practitioner (GP) can and should be a key player in making end-of-life decisions for hospitalised patients, perceptions of GPs' role assigned to them by hospital doctors in making withdrawal decisions for such patients were surveyed.
DESIGN: Questionnaire survey.
SETTING: Urban (districts located near Paris) and rural (southern France) areas.
RESULTS: The response rate was 32.2% (161/500), and it was observed that 70.8% of respondents believed that their participation in withdrawal decisions for their hospitalised patients was essential, whereas 42.1% believed that the hospital doctors were sufficiently skilled to make withdrawal decisions without input from the GPs. Most respondents were found to believe that they had the necessary skills (91.9%) and enough time (87.6%) to participate in withdrawal decisions. The last case of treatment withdrawal in hospital for one of their patients was described by 40% (65/161) of respondents, of whom only 40.0% (26/65) believed that they had participated actively in the decision process. The major factors in the multivariate analysis were the GP's strong belief that his or her participation was essential (p = 0.01), information on admission of the patient given to the GP by the hospital department (p = 0.007), rural practice (p = 0.03), visit to the patient dying in hospital (p = 0.02) and a request by the family to be kept informed about the patient (p = 0.003).
CONCLUSION: Strong interest was evinced among GPs regarding end-of-life issues, as well as considerable experience of patients dying at home. As GPs are more closely corrected to patients' families, they may be a good choice for third-party intervention in making end-of-life decisions for hospitalised patients.
E Ferrand; P Jabre; S Fernandez-Curiel; F Morin; C Vincent-Genod; P Duvaldestin; F Lemaire; C Hervé; J Marty
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of medical ethics     Volume:  32     ISSN:  0306-6800     ISO Abbreviation:  J Med Ethics     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-05     Completed Date:  2007-06-29     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  7513619     Medline TA:  J Med Ethics     Country:  England    
Other Details:
Languages:  eng     Pagination:  683-7     Citation Subset:  E; IM    
Service d'Anesthésie Réanimation SAMU 94, Hôpital Henri-Mondor, AP-HP 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil cedex, France.
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MeSH Terms
Data Collection
Decision Making / ethics*
Ethics, Medical*
Euthanasia / ethics
Inpatients / psychology*
Medical Staff, Hospital / psychology
Patient Participation
Physician's Practice Patterns
Physician-Patient Relations
Physicians, Family / psychology*
Terminal Care / ethics*
Withholding Treatment / ethics

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