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Palliative Medicine, Vol. 21, No. 4, 295-303 (2007)
DOI: 10.1177/0269216307079063

Physician discussions with terminally ill patients: a cross-national comparison

Colleen Cartwright

Aged Services Learning & Research Collaboration, Southern Cross University, Coffs Harbour, NSW 2450, Australia, colleen.cartwright{at}scu.edu.au

Bregje D. Onwuteaka-Philipsen

Vrije Universiteit Medical Centre, Department of Social Medicine and Institute for Research in Extramural Medicine, Amsterdam

Gail Williams

School of Population Health, University of Queensland, Brisbane

Karin Faisst

University of Zurich, Institute of Social and Preventive Medicine, Zurich

Freddy Mortier

University of Ghent, Department of Philosophy and Moral Science, Centre for Environmental Philosophy and Bioethics, Ghent

Tore Nilstun

University of Lund, Department of Medical Ethics, Lund

Michael Norup

University of Copenhagen, Department of Medical Philosophy and Clinical Theory, Copenhagen

Agnes van der Heide

Erasmus MC, University Medical Centre Rotterdam

Guido Miccinesi

Department of Public Health, Rotterdam and Centre for Study and Prevention of Cancer, Epidemiology Unit

A major issue in the care of terminally ill patients is communication and information provision. This paper reports the extent to which physicians in Australia, Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland discuss topics relevant to end of life care with terminally ill patients and their relatives (without first informing the patient), and possible associations between physician-specific characteristics and such discussions. Response rates to the postal survey ranged from 39% to 68% (n =10139). Physicians in most of the countries except Italy `in principle, always' discuss issues related to terminal illness with their patients but not with patients' relatives without first informing the patient, unless the relatives ask. Cross-national differences remained strong after controlling for physician characteristics. The majority of physicians appeared to support the principle of patient-centred care to terminally ill patients, consistent with palliative care philosophy and with the law and/or professional guidelines in most of the countries studied. Palliative Medicine 2007; 21: 295—303

Key Words: Australia • cross-national practices • end-of-life care • EURELD • Europe • physician-patient communication • terminal illness


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