01.12.2014 | Research article | Ausgabe 1/2014 Open Access

Motivations of physicians and nurses to practice voluntary euthanasia: a systematic review
- Zeitschrift:
- BMC Palliative Care > Ausgabe 1/2014
Electronic supplementary material
Competing interests
Authors’ contributions
Background
Methods
Study eligibility criteria
Search strategy
Study selection and data extraction
Theoretical domain
|
Definition
|
Example applied to the field of euthanasia
|
---|---|---|
1. Knowledge
|
An awareness of information related to a given behavior.
|
Knowing the criteria for being admissible for euthanasia in countries where it is legalized.
|
2. Skills
|
An ability to perform a certain act.
|
Having the skills needed to perform voluntary euthanasia.
|
3. Social/professional role and identity
|
How one perceives s/he should act according to his/her social and professional identity.
|
Perceiving euthanasia as compatible with a caregiver’s role.
|
4. Beliefs about capabilities
|
A perceived capacity to adopt a given behavior.
|
Perceiving being able to perform voluntary euthanasia.
|
5. Beliefs about consequences
|
Perceived anticipated consequences of adopting the behavior.
|
Anticipating that euthanasia will have positive consequences for the patient, such as relieving him/her of pain.
|
6. Social influences
|
How one perceives others would react if s/he adopted a given behavior (i.e., approval or disapproval).
|
Perceiving that the patient’s family would approve if the physician euthanized his/her patient.
|
7. Emotions
|
Feelings arising at the thought of adopting the behavior or following behavioral adoption.
|
Feeling guilty or being afraid at the thought of performing euthanasia.
|
8. Moral norm*
|
How a given behavior is perceived according to one’s personal and moral values.
|
Perceiving euthanasia as compatible with one’s personal and moral values.
|
9. Past behavior*
|
Past experience with a given behavior.
|
Having already performed euthanasia in the past.
|
Data analyses
Results
Characteristics of the studies
Reference
|
Country
|
Outcome
|
Sample
|
Theory used
|
Response rate
|
Main results:
|
---|---|---|---|---|---|---|
Positive association (+)
|
||||||
Negative association (-)
|
||||||
No association (0)
|
||||||
Association unknown (+/-)
|
||||||
Asch & DeKay [
20]
|
United States
|
Behavior
|
1 139 critical care nurses:
|
N/A
|
73%
|
• Euthanasia and PAS are unethical (-)
|
Age: 38.5 (8.7)
|
• Passive euthanasia is unethical (-)
|
|||||
5.1% male
|
• Working in cardiac care unit (-)
|
|||||
• Ever asked to engage in euthanasia (+)
|
||||||
Back et al. [
21]
|
United States
|
Behavior
|
828 physicians (GPs and specialists):
|
N/A
|
57%
|
Reasons for not providing euthanasia:
|
Age: NR
|
• Physicians should never perform euthanasia
|
|||||
76.3% male
|
• The symptoms were potentially treatable
|
|||||
• The duration of the patient survival was expected to be > 6 months
|
||||||
• The patient was depressed
|
||||||
• The degree of patient suffering did not justify the request
|
||||||
• Worried about legal consequences
|
||||||
Davis et al. [
22]
|
Australia, Canada, China, Finland, Israel, Sweden and United States
|
Behavior
|
168 cancer care nurses:
|
N/A
|
N/A
|
• Patient wish
|
Age range: 19-64
|
• Severe suffering
|
|||||
% male: NR
|
• Terminally ill
|
|||||
• Family agree
|
||||||
DeKeyser Ganz & Musgrave [
23]
|
Israel
|
Behavior
|
71 critical care nurses
|
N/A
|
N/A
|
Religiosity (-)
|
Doukas et al. [
24]
|
United States
|
Behavior and intention (willing)
|
154 oncologists:
|
Belief-attitude-intention-behavior model of Fishbein
|
61.6%
|
Behavior:
|
Age: 49
|
• University-based oncologists have administered (+)
|
|||||
83% male
|
Intention:
|
|||||
• University-based oncologists willing (+)
|
||||||
• Religion (+/-)
|
||||||
• Global attitude scale (+)
|
||||||
• Philosophical scale (+)
|
||||||
• Alternative attitude scale (+)
|
||||||
Essinger [
25]
|
United States
|
Intention (willingness)
|
365 physicians (GPs and specialists):
|
N/A
|
34%
|
• Deliberate administration of an overdose is never ethically justified
|
Age: 48.7
|
||||||
84.7% male
|
• Euthanasia is inconsistent with the physician’s role to relieve pain and suffering (-)
|
|||||
• Religion (-)
|
||||||
Folker et al. [
26]
|
Denmark
|
Behavior
|
314 physicians (21% GPs):
|
N/A
|
64%
|
• Euthanasia is ethically acceptable
|
Median age: 47
|
• Euthanasia would make me feel uncomfortable
|
|||||
69% male
|
• Euthanasia is incompatible with my role as a physician
|
|||||
Inghelbrecht et al. [
42]
|
Belgium (Flanders)
|
Intention (never prepared to administer lethal drugs)
|
3321 nurses:
|
N/A
|
62.5%
|
• Sex: women vs. men (+)
|
77% older than 36 years
|
• Education: baccalaureate vs. diploma (-)
|
|||||
12.4% male
|
Master vs. diploma (-)
|
|||||
• Religion: Catholic vs. non-religious (+)
|
||||||
Protestant vs. non-religious (+)
|
||||||
Other religion vs. non-religious (+)
|
||||||
• Work setting: home care vs. other (+)
|
||||||
• Experiences with end-of-life decisions with 3 or more patients: yes vs. no (-)
|
||||||
Kinsella & Verhoef [
27]
|
Canada
|
Intention (willingness to practice euthanasia if it were legalized)
|
1391 physicians (GPs and specialists):
|
N/A
|
69%
|
• Sex (+)
|
51% over the age of 40 years
|
• Religious affiliation and activity (+)
|
|||||
78% male
|
• Country of graduation (+)
|
|||||
Kohart [
28]
|
United States
|
Behavior
|
93 physicians (GPs and specialists):
|
N/A
|
42.1%
|
• Relieve patient pain
|
Age: 47
|
• Patient’s desire to die
|
|||||
95.7% male
|
• Reallocate resources
|
|||||
• Relieve family concern
|
||||||
Kuhse & Singer [
29]
|
Australia
|
Behavior
|
869 physicians (GPs and specialists):
|
N/A
|
46%
|
• Euthanasia is not the doctor’s role
|
Age range: < 30 to > 60 years
|
• Euthanasia was the right thing
|
|||||
78.5% male
|
• Respecting the patient’s wish
|
|||||
• It is right for a doctor to take active steps to bring about the death of a patient who has requested the doctor to do this
|
||||||
Kuhse & Singer [
30]
|
Australia
|
Behavior and intention (willingness)
|
943 nurses:
|
N/A
|
49%
|
Behavior:
|
40% of respondents are in their 30s
|
• Euthanasia was the right thing
|
|||||
6% male
|
• Patient request
|
|||||
• Discussion with the family
|
||||||
• Age
|
||||||
• Religion
|
||||||
Intention:
|
||||||
• Age
|
||||||
Kunene & Zungu [
31]
|
South Africa
|
Behavior
|
26 nurses:
|
N/A
|
100%
|
12% would administer a lethal dose of a drug in order to relieve suffering
|
Age: NR
|
||||||
8% male
|
||||||
Maitra et al. [
32]
|
Germany
|
Behavior and intention (willingness)
|
233 GPs:
|
N/A
|
48%
|
Behavior:
|
Age: 51
|
• Euthanasia was right in a moral sense
|
|||||
68% male
|
• Have received requests for euthanasia in the past (+)
|
|||||
Matzo [
33]
|
United States
|
Behavior
|
441 oncology nurses:
|
N/A
|
74%
|
• Being married (0)
|
Age: 42.0 (8.5)
|
• Being Jewish (0)
|
|||||
2% male
|
• Being Catholic (0)
|
|||||
• Income (0)
|
||||||
• Race (0)
|
||||||
• Age (0)
|
||||||
• Religiosity (0)
|
||||||
• Gender (0)
|
||||||
• Highest degree (0)
|
||||||
• Years since graduation (0)
|
||||||
• Catholic religiosity (0)
|
||||||
• Jewish religiosity (0)
|
||||||
Meeusen et al. [
43]
|
Belgium
|
Behavior
|
205 GPs:
|
N/A
|
91.9%
|
Reasons for granting a patient’s request:
|
Age: NR
|
• Explicit & repeated request from patient
|
|||||
% male: NR
|
• Written request
|
|||||
Reasons for not granting a patient’s request:
|
||||||
• Patient’s wish was not explicit & repeated
|
||||||
• Patient’s suffering was not unbearable & persistent
|
||||||
Meier et al. [
34]
|
United States
|
Behavior
|
379 physicians:
|
N/A
|
63%
|
• Patient depressed at the time of request (-)
|
Age: NR
|
• Patient in severe discomfort other than pain (+)
|
|||||
% male: NR
|
• Patient life expectancy < 1 month (+)
|
|||||
Obstein et al. [
44]
|
The Netherlands
|
Behavior
|
30 physicians:
|
N/A
|
100%
|
• Positive experience with euthanasia
|
Age: 49.3
|
• No regrets after performing euthanasia
|
|||||
86.7% male
|
• Euthanasia is part of the role of a physician
|
|||||
• Euthanasia challenges personal morals
|
||||||
Onwuteaka-Philipsen et al. [
35]
|
Australia, Belgium, Denmark, Italy, The Netherlands, Sweden and Switzerland (before 2002)
|
Intention (willingness to perform end-of-life decisions)
|
10 139 physicians (GPs and specialists):
|
N/A
|
57.1% (overall)
|
• Request of patient with decisional capacity (+)
|
Age: NR
|
• Advance directive of subcomatose patient (+)
|
|||||
% male: NR
|
• Request of family of patient with decisional capacity (-)
|
|||||
• Subcomatose patient, request of the family (+)
|
||||||
• Subcomatose patient, own initiative of physician (+)
|
||||||
• Life expectancy < 2 weeks (+)
|
||||||
• Uncontrollable pain (+)
|
||||||
• Religious, important for professional attitude (-)
|
||||||
Onwuteaka-Philipsen et al. [
45]
|
The Netherlands
|
Behavior
|
6263 physicians (GPs and specialists):
|
N/A
|
74%
|
Reasons for granting requests:
|
Age: NR
|
• Wish of the patient
|
|||||
% male: NR
|
• No prospect of improvement
|
|||||
• No more options for treatment
|
||||||
• Loss of dignity
|
||||||
Oz [
36]
|
Turkey
|
Behavior and intention (willingness)
|
113 nurses:
|
N/A
|
Nurses: 39% Physicians: 31.8%
|
Nurses’ willingness to participate in legal euthanasia:
|
Age: 78% between 20-30
|
• Age (0)
|
|||||
0% male
|
Physicians’ willingness to participate in legal euthanasia:
|
|||||
84 physicians:
|
• Age: 20-30 vs. 31+ (+)
|
|||||
Age: 65.5% between 20-30
|
Nurses’ reasons for wanting to make their patient’s death easy according to years of experience:
|
|||||
79.8% male
|
||||||
• Pain and depression: 7+ years vs. 1-6 years (+)
|
||||||
Physicians’ reasons for wanting to make their patient’s death easy according to years of experience:
|
||||||
• Pain and depression: 1-6 years vs. 7+ years: (+)
|
||||||
• Insufficient support: 7+ years vs. 1-6 years (+)
|
||||||
Parker et al. [
37]
|
Australia
|
Intention (willingness)
|
1478 physicians (GPs and specialists):
|
N/A
|
53%
|
Case 1: competent patient, life expectancy < 2 weeks: Anesthetists vs. palliative care specialists and oncologists (+)
|
> 70% aged 40 or more
|
||||||
Case 2: competent patient, life expectancy > 3 months: Anesthetists vs. palliative care specialists and oncologists (+)
|
||||||
78% male
|
Case 3: incompetent patient, life expectancy < 2 weeks:
Anesthetists vs. palliative care specialists and geriatricians (+)
|
|||||
Case 4: incompetent patient, life expectancy > 3 months: Anesthetists vs. palliative care specialists and geriatricians (+)
|
||||||
Richardson [
38]
|
United States
|
Behavior and intention (attitude)
|
148 oncology nurses:
|
Kohlberg’s model of moral reasoning development
|
74%
|
Behavior:
|
Age: NR
|
• Religious attitude to euthanasia (-)
|
|||||
% male: NR
|
||||||
Shapiro et al. [
39]
|
United States
|
Intention (willingness)
|
740 physicians (GPs and specialists):
|
N/A
|
33%
|
Willingness to perform euthanasia:
|
Age: 55.1% between 35-60
|
• Family/general practice vs. other specialty or internal medicine (+)
|
|||||
84% male
|
• Christian fundamentalists vs other religions (Protestant, other) (-)
|
|||||
• Catholic vs. other religions (Protestant, other) (-)
|
||||||
• Jewish vs. other religions (Protestant, other) (+)
|
||||||
• Specified no religion vs. other religions (Protestant, other) (+)
|
||||||
Willingness to perform euthanasia if it were legalized:
|
||||||
• Family/general practice vs. other specialty or internal medicine (+)
|
||||||
• Christian fundamentalist vs. other religions not in analysis (-)
|
||||||
• Catholic vs. other religions not in this analysis (Protestant, other), and for uncertain outcome (Christian fundamentalist, Jewish) (-)
|
||||||
• Jewish vs. other religions not in this analysis (Protestant, other) (+)
|
||||||
• Specified no religion vs. other religions not in analysis (+)
|
||||||
Smets et al. [
46]
|
Belgium
|
Behavior
|
914 physicians (GPs and specialists):
|
N/A
|
34%
|
Religious affiliation/philosophy of life:
|
Age: 45.1% between 51-65
|
• Roman Catholic/strong practicing vs. not religious (-)
|
|||||
63.5% male
|
• Roman Catholic/moderately practicing vs. not religious (-)
|
|||||
• Roman Catholic/not practicing vs. not religious (-)
|
||||||
• Religious, but no specific denomination vs. not religious (-)
|
||||||
Specialty:
|
||||||
• Specialist vs. general practitioner (+)
|
||||||
Age (years):
|
||||||
• 36-50 vs. < 35 (+)
|
||||||
• 51-65 vs. < 35 (+)
|
||||||
• > 65 vs. < 35 (+)
|
||||||
Training in palliative care: yes vs. no (+)
|
||||||
Number of terminal patients cared for in the last 12 months:
• 1-9 vs. 0 (+)
|
||||||
• ≥ 10 vs. 0 (+)
|
||||||
Stevens & Hassan [
40]
|
Australia
|
Behavior
|
298 physicians:
|
N/A
|
68%
|
Strong association between taking active steps and belief that such action was ‘right’
|
Age: NR
|
Reasons why they felt they had done the ‘right’ thing:
|
|||||
% male: NR
|
• This action had relieved pain, suffering and distress experienced by the patient
|
|||||
• The patient was near death
|
||||||
• The situation was hopeless
|
||||||
• The patient had no prospect of a meaningful or independent existence
|
||||||
• Acted on orders
|
||||||
Stevens & Hassan [
41]
|
Australia
|
Behavior
|
278 nurses:
|
N/A
|
55%
|
Sex: male vs. female
|
Age range: 20-59
|
||||||
6.5% male
|
Reference
|
Response rate ≥ 60%
|
Verified whether respondents differed from non-respondents
|
Cases-to-predictors ratio > 15 for multivariate analyses
|
---|---|---|---|
Asch & DeKay [
20]
|
√
|
√
|
|
Back et al. [
21]
|
√
|
N/A
|
|
Davis et al. [
22]
|
NR
|
NR
|
|
DeKeyser Ganz & Musgrave [
23]
|
NR
|
N/A
|
|
Doukas et al. [
24]
|
√
|
N/A
|
|
Essinger [
25]
|
N/A
|
||
Folker et al. [
26]
|
√
|
√
|
NR
|
Inghelbrecht et al. [
42]
|
√
|
√
|
N/A
|
Kinsella & Verhoef [
27]
|
√
|
√
|
N/A
|
Kohart [
28]
|
NR
|
||
Kuhse & Singer [
29]
|
NR
|
||
Kuhse & Singer [
30]
|
NR
|
||
Kunene & Zungu [
31]
|
√
|
NR
|
|
Maitra et al. [
32]
|
√
|
||
Matzo [
33]
|
√
|
√
|
√
|
Meeusen et al. [
43]
|
√
|
NR
|
|
Meier et al. [
34]
|
√
|
√
|
|
Obstein et al. [
44]
|
√
|
NR
|
|
Onwuteaka-Philipsen et al. [
35]
|
√
|
√
|
|
Onwuteaka-Philipsen et al. [
45]
|
√
|
NR
|
|
Oz [
36]
|
N/A
|
||
Parker et al. [
37]
|
N/A
|
||
Richardson [
38]
|
√
|
N/A
|
|
Shapiro et al. [
39]
|
√
|
√
|
|
Smets et al. [
46]
|
√
|
√
|
|
Stevens & Hassan [
40]
|
√
|
NR
|
|
Stevens & Hassan [
41]
|
N/A
|
Characteristics of the participants
Most consistent variables associated with behavior and/or intention
Variables measured
|
Number of time
|
Ratio
|
|
---|---|---|---|
Assessed
|
Significant (
p < 0.05)
|
(%)
|
|
Psychological variables*
|
|||
Past behavior
|
3
|
3
|
100%
|
Beliefs about consequences
|
5
|
2
|
40.0%
|
Social/professional role and identity
|
6
|
2
|
33.3%
|
Beliefs about capabilities
|
3
|
1
|
33.3%
|
Moral norm
|
9
|
2
|
22.2%
|
Emotions
|
1
|
0
|
N/A
|
Total
|
27
|
10
|
37.0%
|
Socio-
demographic variables**
|
|||
Medical specialty, unit and work setting
|
9
|
6
|
66.6%
|
Religion
|
17
|
7
|
41.2%
|
Number of terminal patients
|
3
|
1
|
33.3%
|
Gender
|
10
|
3
|
30.0%
|
Level of education
|
4
|
1
|
25.0%
|
Years of work experience
|
5
|
1
|
20.0%
|
Age
|
12
|
2
|
16.6%
|
Marital status
|
3
|
0
|
0%
|
Place of birth
|
2
|
1
|
N/A
|
Had training in palliative care
|
1
|
1
|
N/A
|
Income
|
1
|
0
|
N/A
|
Ethnicity
|
1
|
0
|
N/A
|
Total
|
68
|
23
|
33.8%
|
Patient variables**
|
|||
Patient depressed
|
3
|
2
|
66.6%
|
Patient’s life expectancy
|
5
|
3
|
60.0%
|
Patient’s symptoms and suffering
|
10
|
4
|
40.0%
|
Family agreement
|
4
|
1
|
25.0%
|
Patient’s wish
|
7
|
1
|
14.3%
|
Condition with no prospect of improvement
|
4
|
0
|
0%
|
Loss of dignity
|
1
|
0
|
N/A
|
To reallocate resources
|
1
|
0
|
N/A
|
Total
|
35
|
11
|
31.4%
|
Most consistent variables associated with behavior and/or intention according to health profession
Variables measured
|
Number of time
|
Ratio
|
|
---|---|---|---|
Assessed
|
Significant (
p < 0.05)
|
(%)
|
|
Physicians (k = 17)
|
|||
Psychological variables
|
|||
Beliefs about consequences
|
5
|
2
|
40.0%
|
Social/professional role and identity
|
6
|
2
|
33.3%
|
Moral norm
|
7
|
1
|
14.3%
|
Beliefs about capabilities
|
2
|
1
|
N/A
|
Past behavior
|
1
|
1
|
N/A
|
Emotions
|
1
|
0
|
N/A
|
Total
|
22
|
7
|
31.8%
|
Socio-
demographic variables
|
|||
Medical specialty, unit and work setting
|
6
|
4
|
66.6%
|
Religion
|
9
|
5
|
55.5%
|
Number of terminal patients
|
3
|
1
|
33.3%
|
Age
|
5
|
1
|
20.0%
|
Gender
|
6
|
1
|
16.6%
|
Had training in palliative care
|
1
|
1
|
N/A
|
Place of birth
|
1
|
1
|
N/A
|
Years of experience
|
1
|
0
|
N/A
|
Marital status
|
1
|
0
|
N/A
|
Total
|
33
|
14
|
42.4%
|
Patient variables
|
|||
Patient’s life expectancy
|
4
|
3
|
75.0%
|
Patient’s symptoms and suffering
|
7
|
4
|
57.1%
|
Patient’s wish
|
5
|
1
|
20.0%
|
Condition with no prospect of improvement
|
4
|
0
|
0%
|
Patient depressed
|
2
|
2
|
N/A
|
Family agreement
|
2
|
1
|
N/A
|
Loss of dignity
|
1
|
0
|
N/A
|
To reallocate resources
|
1
|
0
|
N/A
|
Total
|
26
|
11
|
42.3%
|
Nurses (k = 9)
|
|||
Psychological variables
|
|||
Past behavior
|
2
|
2
|
N/A
|
Moral norm
|
2
|
1
|
N/A
|
Total
|
4
|
3
|
75%
|
Socio-
demographic variables
|
|||
Medical specialty, unit and work setting
|
3
|
2
|
66.6%
|
Gender
|
4
|
2
|
50.0%
|
Religion
|
8
|
2
|
25.0%
|
Level of education
|
4
|
1
|
25.0%
|
Age
|
6
|
0
|
0%
|
Years of experience
|
3
|
0
|
0%
|
Marital status
|
2
|
0
|
N/A
|
Place of birth
|
1
|
0
|
N/A
|
Income
|
1
|
0
|
N/A
|
Ethnicity
|
1
|
0
|
N/A
|
Total
|
33
|
7
|
21.2%
|
Patient variables
|
|||
Patient’s symptoms and suffering
|
2
|
0
|
N/A
|
Patient’s wish
|
2
|
0
|
N/A
|
Family agreement
|
2
|
0
|
N/A
|
Patient’s life expectancy
|
1
|
0
|
N/A
|
Total
|
7
|
0
|
0%
|
Most consistent variables associated with behavior and/or intention according to legal status of euthanasia
Variables measured
|
Number of time
|
Ratio
|
|
---|---|---|---|
Assessed
|
Significant (
p < 0.05)
|
(%)
|
|
Countries were euthanasia is not legal (k = 22)
|
|||
Psychological variables
|
|||
Beliefs about consequences
|
3
|
2
|
66.6%
|
Social/professional role and identity
|
5
|
2
|
40.0%
|
Beliefs about capabilities
|
3
|
1
|
33.3%
|
Moral norm
|
8
|
2
|
25.0%
|
Past behavior
|
2
|
2
|
N/A
|
Emotions
|
1
|
0
|
N/A
|
Total
|
22
|
9
|
40.9%
|
Socio-demographic variables
|
|||
Medical specialty, unit and work setting
|
7
|
4
|
57.1%
|
Religion
|
15
|
5
|
33.3%
|
Years of experience
|
4
|
1
|
25.0%
|
Gender
|
9
|
2
|
22.2%
|
Age
|
10
|
1
|
10.0%
|
Level of education
|
3
|
0
|
0%
|
Marital status
|
3
|
0
|
0%
|
Place of birth
|
2
|
1
|
N/A
|
Number of terminal patients
|
2
|
0
|
N/A
|
Income
|
1
|
0
|
N/A
|
Ethnicity
|
1
|
0
|
N/A
|
Total
|
57
|
14
|
24.6%
|
Patient variables
|
|||
Patient depressed
|
3
|
2
|
66.6%
|
Patient’s life expectancy
|
5
|
3
|
60.0%
|
Patient’s symptoms and suffering
|
9
|
4
|
44.4%
|
Family agreement
|
4
|
1
|
25.0%
|
Patient’s wish
|
5
|
1
|
20.0%
|
Condition with no prospect of improvement
|
2
|
0
|
N/A
|
To reallocate resources
|
1
|
0
|
N/A
|
Total
|
29
|
11
|
37.9%
|
Countries where euthanasia is legal (k = 5)
|
|||
Psychological variables
|
|||
Beliefs about consequences
|
2
|
0
|
N/A
|
Past behavior
|
1
|
1
|
N/A
|
Social/professional role and identity
|
1
|
0
|
N/A
|
Moral norm
|
1
|
0
|
N/A
|
Total
|
5
|
1
|
20.0%
|
Socio-
demographic variables
|
|||
Medical specialty, unit and work setting
|
2
|
2
|
N/A
|
Religion
|
2
|
2
|
N/A
|
Age
|
2
|
1
|
N/A
|
Gender
|
1
|
1
|
N/A
|
Had training in palliative care
|
1
|
1
|
N/A
|
Number of terminal patients
|
1
|
1
|
N/A
|
Level of education
|
1
|
1
|
N/A
|
Total
|
10
|
9
|
90.0%
|
Patient variables
|
|||
Patient’s wish
|
2
|
0
|
N/A
|
Condition with no prospect of improvement
|
2
|
0
|
N/A
|
Patient’s symptoms and suffering
|
1
|
0
|
N/A
|
Loss of dignity
|
1
|
0
|
N/A
|
Total
|
6
|
0
|
0%
|