NCPA - National Center for Policy Analysis


March 25, 2005

Life-prolonging treatment is either not given or is withdrawn at the end of life for a substantial proportion of patients in six European countries, a survey of doctors has found. Although the figures varied by country, in most places medicine was the treatment most often not given, followed by fluids or nutrition.

The report in the February 28 issue of the Archives of Internal Medicine about how frequently care was withheld or withdrawn at the end of life demonstrated dramatic differences among six European countries.

  • Italy had the lowest percentage of deaths associated with "non-treatment" at 6 percent.
  • In five of the six European countries decisions not to treat were made in more than 20 percent of deaths.
  • In Switzerland, a wealthy country with a very sophisticated, modern medical system, non-treatment was reported in 41 percent of deaths.

Although the United States was not included in the study, LeWine suspects that doctors in our country withhold or withdraw treatment even less frequently than the Italians.

Why are things so different in America? According to LeWine, one can point to many possible explanations, such as the positive, optimistic, never-say-die American spirit (overall a very good attribute for society); the incredible medical advances that we hear and read about every day; the dramatic medical saves in the movies and on television; and how the rare story of a person waking up from a prolonged coma overshadows the thousands kept alive by tube feedings.

Source: Howard LeWine "Treatments Withheld at End of Life,", March 1, 2005; and Bosshard et al., "Forgoing Treatment at the End of Life in 6 European Countries," Archives of Internal Medicine, Vol. 165, Issue 4, February 28, 2005.

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