The Pharmaceutical Journal
Vol 276 No 7384 p63
21 January 2006

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Doctors in UK surveyed about end-of-life decisions

One in three patients died after doctors administered treatment to alleviate symptoms knowing that it might shorten life, according to research due to be published next week.

And 30 per cent of deaths that doctors dealt with in 2004 were due to “non-treatment decisions” where treatment was either withdrawn or withheld, it revealed.
Results from the anonymous survey conducted by Colin Seale from Brunel University suggest that less than 1 per cent of UK deaths (0.16 per cent) can be attributed to voluntary euthanasia, where a patient asks a doctor to help end his or her life and the clinician administers a lethal drug.

Professor Seale also discovered that doctors were involved in 0.33 per cent of deaths where patients had made an advanced directive about their wish to end their life.
None of the 857 doctors who took part in the survey said they had taken part in any physician-assisted suicides in 2004 — cases where patients wanting to die request medication from a doctor but administer the drugs themselves.

The results of the UK survey were compared with results from the same questionnaire sent to doctors in the Netherlands, Australia, New Zealand, Belgium, Italy, Denmark, Sweden and Switzerland.

Professor Seale found that rates of voluntary euthanasia and physician-assisted suicide were more frequent in the Netherlands and Australia than in the UK. Physician-assisted suicide was also less common in the UK than in Switzerland.

Advanced directives or “living wills” featured more commonly in patient deaths in Belgium and Australia than in the UK, and the withholding or withdrawing of treatment was more common in the UK than in other parts of Europe.

Commenting on the results, Professor Seale said: “This is the first time that a nationally representative survey of end-of-life decisions taken by doctors in the UK has been done and it has produced some interesting results. Euthanasia and physician-assisted suicide are understandably emotive subjects but this work shows that UK doctors are less willing to take such actions than [doctors] in several other countries.” He said the results reflect the “strong ethos” in the UK of providing “excellent palliative care” and showed that “doctors in the UK are willing to make other kinds of decisions that prioritise the comfort of patients, without striving to preserve life at the cost of suffering”.

The study details were revealed the same week as the law and ethics committee of the Royal Pharmaceutical Society was due to meet to take the first steps in drawing up professional guidance on euthanasia and physician-assisted suicide. The committee declined to comment after the meeting but confirmed the guidance was “work in progress”.
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