Browsing by Author "Hausmann, C."

Empirical research on euthanasia and medical decisions at the end of life usually focus on the doctors' perspective. The perspectives of patients, relatives respectively the bereaved families have been neglected so far. The project,Patients as partners. Tumour patients and their participation" aims to improve the participation of tumour patients in medical decision making at the end of life by means of several offerings for patients. In order to develop a theoretical model, interviews were conducted with patients, relatives, doctors and members of the bereaved families. Between March 2002 and July 2004 questionnaires were sent to the bereaved families about eight to ten weeks after their relatives had perished. Before dying, the patients had been looked after and offered consultation by a palliative care team either in hospital or at home. Results: Of 151 sent out questionnaires, 59.6% (n = 90) were filled in and sent back by members of the bereaved families. 52.3% of the patients had died in hospital, 33.7% in their private home. All of the patients who died at home, but only one in three patients who died in hospital also wanted to die there. The relatives were predominantly very satisfied or satisfied with the medical care (67.8%). 11% of the bereaved families said, their dying relatives had seriously asked for euthanasia. In 74.4% of all cases, decisions for the renunciation of therapy were made, mostly due to a worsening of the general condition (54.4%) or a progress of the disease (46.6%). Conclusion: The questioning was successfully conducted. Members of bereaved families are able and also prepared to answer questions about the last days of their relatives lives. The question about the desired dying place has proved to be workable. In empirical research, the perspective of the relatives and bereaved families should be taken in to account seriously.

Medical decision-making models focus on doctor-patient relationship. The impact of the family, specifically the involvement of the relatives in the information- and decision-making process have rarely been evaluated yet. Within the project,Patient as partners - cancer patients and their involvement in medical decision making" progressive disease cancer patients, their relatives and doctors as well as Thuringian general practitioners have been interviewed with regard to their attitudes (among others) towards the medical system and information and decision making processes. Results: From the patient's point of view, the family is highly important in decision-making (very important/important 80.3%). 73% of the patients, but only 58% of the relatives feel very good/good informed about the treatment. With regard to prognosis, 30% of the patients and 27% of the relatives feel less/poorly informed. 83.7% of the relatives believe they cannot influence treatment decisions. According to this, Thuringian general practitioners judge the influence of family members on treatment decisions quite low (very high/high 12.9%, partly 37.4%, low/not possible 49.7%), though the relatives' wish for involvement is seen quite realistic (89% of the GP's believe that the family wants to be involved). Conclusion: From the patients point of view, the family has got a high status with regard to medical decision-making. In palliative cancer patients doctors should offer an early and continuous involvement of relatives in information and decision-making processes in order to reduce misjudgements and frustration within the families.