[Difficulties and shortcomings in decisions on treatment restrictions]

Using a questionnaire for doctors at the Central hospital in Kristianstad, Sweden, we have investigated how work on treatment restrictions is handled and documented, whether different circumstances affect the decisions taken, and what support and training the doctors consider is needed. Far from all patients/relatives are informed about decisions regarding life support treatment, and compliance with applicable laws and directives is low. The propensity to inform tend to be lower when the decision is that no life-sustaining measures will be taken. The decisions also tend not to be affected by several factors related to the patient, doctor, or the circumstances in which the decision was taken. The self-perceived level of knowledge, especially about documentation routines and current guidelines, is low and there are also shortcomings in terms of knowledge about palliative care, communication methodology and medical ethics.