[Physicians' Directions about Artificial Hydration and Nutrition at End-of-Life]

To conduct a questionnaire survey to elicit physicians' directions about artificialhydration and nutrition at end-oflife.

A questionnaire was sent to 2,773 randomly selected Japanese physicians who were registrants of Rakuten Research Inc.(Tokyo, Japan). Of the respondents, 500 returned the questionnaire, and their reposes were analyzed. The Fisher's exact test was used to compare the respective responses.

Of the 500 physicians, 22.4%(112)chose to discontinue artificialhydration and nutrition for those who are at terminalstage and could no longer communicate. On the other hand, 20.8%(104/500)of the physicians chose to continue artificialhydration and nutrition for those who were confined to bed and had the tendency to self-remove drip infusion or other tubes. Significantly more physicians who were working in hospitals than in private clinics chose to continue artificial hydration and nutrition(27% vs 3%; p<0.00001).

Our findings revealed that 20.8% of physicians did not know about the latest evidence of end-of-life care to uphold patient dignity until the end-of-life. As our results might be different from the practice in other facilities located abroad, we must adopt prudent guidelines for palliative and end-of-life care and enlighten physicians and medical students regarding the current guidelines.