End of life decision-making by New Zealand general practitioners: A national survey

Abstract

Aim: To explore type and incidence of medical decisions at the end of life that hasten death made by general practitioners in New Zealand, within the context of access to palliative care. Method: An anonymous questionnaire investigating the last death attended in the previous 12 months was sent to 2602 general practitioners (GPs) in New Zealand. Results: From a 48% (1255) response, 88.9% (1116) GPs indicated access to an interdisciplinary pain management or palliative care team. Of those attending a death in the previous 12 months, 63% (693) had made a prior medical decision. These decisions included withdrawing/withholding treatment or increasing pain relief with (a) probability death would be hastened 61.8% (428) or (b) partly or explicitly to hasten death 32.6% (226). Moreover, death was caused by a drug supplied or administered by the GP in 5.6% cases (39), actions consistent with physician-assisted death. Conclusion: Physician-assisted death provided by some general practitioners in New Zealand is occurring within the context of available palliative care.