Impact of specialty on attitudes of Australian medical practitioners to end-of-life decisions

Parker, Malcolm H., Cartwright, C and Williams, Gail M. (2008) Impact of specialty on attitudes of Australian medical practitioners to end-of-life decisions. Medical Journal of Australia, 188 8: 450-456.

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Author Parker, Malcolm H.
Cartwright, C
Williams, Gail M.
Title Impact of specialty on attitudes of Australian medical practitioners to end-of-life decisions
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
Publication date 2008-01-01
Year available 2008
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 188
Issue 8
Start page 450
End page 456
Total pages 7
Editor Van Der Weyden, M.
Place of publication Australia
Publisher Australasian Medical Publishing Company Pty Ltd
Language eng
Subject C1
220106 Medical Ethics
950401 Bioethics
Abstract Objective: To compare attitudes and practices of Australian medical practitioners, by specialty, to a range of medical decisions at the end of life. Design, setting and participants: As part of an international study, in 2003, a structured questionnaire was mailed to 2964 medical practitioners drawn from membership registers of Australian and Australasian professional colleges. Data from 1478 questionnaires were statistically analysed using validated instruments. Main outcome measures: Practitioners’ willingness to comply with requests from patients and/or their relatives for symptom relief which might also hasten death; provision of terminal sedation and euthanasia, or willingness to provide these on their own initiative. Results: Respondents reported being much more willing to comply with a patient’s request for increasing symptom relief, even at risk of hastening death, than for terminal sedation. Over a quarter of respondents would provide terminal sedation to competent patients on their own initiative. A small number of respondents would intentionally hasten death. There were significant differences by specialty for all three actions. Oncologists, palliative care physicians and geriatricians were least likely to actively hasten death, and more likely to act unilaterally to relieve symptoms as a medical necessity. Conclusions: Perceptions about the causation of death and aspects of medical culture appear to influence physicians’ attitudes towards medical decisions at the end of life. Our findings have implications for medical education, interprofessional communication and discussion between the medical profession and the community.
Keyword Medicine, General & Internal
General & Internal Medicine
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 25 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 22 times in Scopus Article | Citations
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Created: Tue, 24 Mar 2009, 23:44:46 EST by Helen Spindler on behalf of School of Medicine