End-of-life decisions and involvement of Physical and Rehabilitation Medicine Physicians in Europe.
Rutger Osterthun, Katharina S Sunnerhagen, Henk J Stam and 1 others
PMID 37387681WHAT IT FOUND
Rehabilitation physicians are involved in end-of-life decisions in most European countries where these decisions are legal, but their role varies widely.
They act mainly as external specialists. In several countries where such decisions are legal, rehabilitation physicians reported no involvement at all.
Key findings
01Rehabilitation physicians are involved in end-of-life care for neurological conditions in most participating countries, primarily as external specialists providing advice rather than managing overall care.
02Involvement in end-of-life decisions was reported in most countries where these decisions were legal, but there were notable exceptions where legal status did not lead to physician involvement.
03There is a significant regional divide, with non-treatment decisions and potentially life-shortening drugs being more frequently legal and involving rehabilitation physicians in Northern and Western Europe compared to Southern and Eastern Europe.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The survey relied on delegates estimating the practice of their entire country, which may not reflect the views or experiences of all rehabilitation physicians. The response rate was lower in Northern and Southern Europe, potentially introducing bias. The survey instrument was self-constructed with limited validation, and definitions of end-of-life decisions may have been interpreted differently by respondents. The study did not measure the frequency of end-of-life decisions or patient satisfaction, only the perceived involvement of physicians. Only delegates of a specific professional section were surveyed, which may not represent the broader rehabilitation community.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that rehabilitation physicians are routinely involved in end-of-life decisions in every European country, even where such decisions are legal. The survey showed that in several countries with legal non-treatment decisions or life-shortening drugs, respondents reported no involvement of rehabilitation physicians.