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Related Experiment Videos

Life-terminating acts without explicit request of patient

L Pijnenborg1, P J van der Maas, J J van Delden

  • 1Department of Public Health, Erasmus University, Rotterdam, Netherlands.

Lancet (London, England)
|May 8, 1993
PubMed
Summary
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Life-terminating acts without explicit patient request (LAWER) occurred in 0.8% of Dutch deaths. These acts often involved younger, male cancer patients, with physicians reporting unbearable suffering and exhausted palliative care options.

Area of Science:

  • Medical Ethics
  • End-of-Life Care Research
  • Public Health Studies

Background:

  • Medical decisions concerning the end of life (MDEL) are a critical aspect of healthcare.
  • Life-terminating acts without the explicit request of the patient (LAWER) represent a small but significant proportion of deaths.
  • Understanding the nuances of LAWER is crucial for ethical medical practice and patient advocacy.

Purpose of the Study:

  • To provide quantitative data on the incidence and characteristics of LAWER in the Netherlands.
  • To discuss the key ethical and practical issues surrounding LAWER.
  • To explore physician perspectives on LAWER in the context of end-of-life decisions.

Main Methods:

  • Analysis of data from a Dutch nationwide study on medical decisions concerning the end of life (MDEL).
Keywords:
Death and EuthanasiaEmpirical Approach

Related Experiment Videos

  • Quantitative assessment of LAWER cases, including patient demographics and physician-patient relationships.
  • Qualitative insights derived from physician interviews regarding decision-making processes and patient conditions.

    • Main Results:

    • LAWER accounted for 0.8% of all deaths in the study.
    • Patients undergoing LAWER were often younger, male, and had cancer.
    • Physicians reported patient's unbearable suffering, lack of improvement, and exhausted palliative care in most LAWER cases.

    Conclusions:

    • LAWER involves complex ethical considerations, often occurring when explicit patient wishes cannot be ascertained.
    • While overall MDEL may increase, LAWER rates might decrease, though some cases may necessitate such decisions.
    • Physician-reported factors like unbearable suffering and lack of alternatives strongly influence LAWER decisions.