Wishes to Die of Palliative Cared People in Serious Illness

Linda Sommer

How do physicians describe and evaluate their role in end-of-life decision-making and their influence in the dying process?

Medical decisions and measures at the end of life are closely linked to the values and views of the physicians providing care. We would like to investigate how physicians describe and evaluate their role in relation to the dying process of their patients and what significance they themselves ascribe to their role in the end-of-life decision-making process. What influence do physicians have, from their own perspective, on the patient's dying? In which language, i.e. with which terms and categories do they themselves describe their actions in the context of euthanasia?

For this purpose, 10-15 semi-structured interviews with mainly intensive care and palliative care physicians in Germany will be conducted and evaluated using an ethical-empirical research approach. The aim of this study is to better understand the physician's view of the dying process and decision-making at the end of life in the context of the physicians' experience. Against the background of recent published studies, the aim is to clarify the relationship between the concepts used by physicians in everyday life to categorize their actions and the categories used in the legal-ethical discourse on euthanasia in Germany: Where are similarities? Where are some differences?

Previous results of the interview analysis suggest a heterogeneous understanding of the role of physicians in relation to the dying process and show that decision-making at the end of life usually takes place with the superior goal of alleviating suffering for the patient. The forms of euthanasia practiced by physicians in outpatient and inpatient settings seem to be rarely associated with the existing legal categories of euthanasia in their everyday work. It seems to be much more important for physicians to have a practical terminology and an implicit knowledge of possible courses of action with regard to the care of their patients during dying.

This research aims to contribute to a better understanding of physicians' agency at the end of life and to show whether and to what extent a unified language exists for the debate about end-of-life decisions.