Issues and needs in end-of-life decision making: An international modified Delphi study

Natasja Raijmakers, Lia Zuylen, M Costantini, A Caraceni, JB Clark, G De Simone, G Lundquist, R Voltz, JE (John) Ellershaw, Agnes van der Heide

Research output: Contribution to journalArticleAcademicpeer-review

32 Citations (Scopus)

Abstract

Background: end-of-life decision making is an important aspect of end-of-life care that can have a significant impact on the process of dying and patients' comfort in the last days of life. Aim: the aim of our study was to identify issues and considerations in end-of-life decision making, and needs for more evidence among palliative care experts, across countries and professions. Participants: 90 palliative care experts from nine countries participated in a modified Delphi study. Participants were asked to identify important issues and considerations in end-of-life decision making and to rate the need for more evidence. Results: experts mentioned 219 issues in end-of-life decision making related to the medical domain, 122 issues related to the patient wishes and 92 related to relatives' wishes, regardless of profession or country (p > 0.05). In accordance, more than 90% of the experts rated the comfort and wishes of the patient and the potential futility of treatment as important considerations in end-of-life decision making, although some variation was present. When asked about issues that are in need of more Conclusions: palliative care experts from different professions in different countries encounter similar issues in end-of-life decision making. Adequate communication about these issues is universally experienced as a challenge, which might benefit from increased knowledge. This shared experience enables and emphasizes the need for more international research.
Original languageUndefined/Unknown
Pages (from-to)947-953
Number of pages7
JournalPalliative Medicine
Volume26
Issue number7
DOIs
Publication statusPublished - 2012

Research programs

  • EMC NIHES-02-65-01
  • EMC OR-01-86-13

Cite this