Physicians' attitudes towards end-of-life decisions: a comparison between seven countries

In the context of an European collaborative research project (EURELD), a study on attitudes towards medical end-of-life decisions was conducted among physicians in Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. Australia also joined the consortium. A written questionnaire with structured questions was sent to practising physicians from specialties frequently involved in the care of dying patients. 10,139 questionnaires were studied. Response rate was equal to or larger than 50% in all countries except Italy (39%). Apart from general agreement with respect to the alleviation of pain and symptoms with possible life-shortening effect, there was large variation in support-between and within countries-for medical decision that may result in the hastening of death. A principal component factor analysis found that 58% of the variance of the responses is explained by four factors. 'Country' explained the largest part of the variation of the standardized factor scores. (c) 2004 Elsevier Ltd. All rights reserved.

End-of-life decision making in Europe and Australia - A physician survey

Background: The frequencies with which physicians make different medical end-of-life decisions (ELDs) may differ between countries, but comparison between countries has been difficult owing to the use of dissimilar research methods. Methods: A written questionnaire was sent to a random sample of physicians from 9 specialties in 6 European countries and Australia to investigate possible differences in the frequencies of physicians' willingness to perform ELDs and to identify predicting factors. Response rates ranged from 39% to 68% (N= 10 139). Using hypothetical cases, physicians were asked whether they would ( probably) make each of 4 ELDs. Results: In all the countries, 75% to 99% of physicians would withhold chemotherapy or intensify symptom treatment at the request of a patient with terminal cancer. In most cases, more than half of all physicians would also be willing to deeply sedate such a patient until death. However, there was generally less willingness to administer drugs with the explicit intention of hastening death at the request of the patient. The most important predictor of ELDs was a request from a patient with decisional capacity (odds ratio, 2.1-140.0). Shorter patient life expectancy and uncontrollable pain were weaker predictors but were more stable across countries and across the various ELDs (odds ratios, 1.1-2.4 and 0.9-2.4, respectively). Conclusion: Cultural and legal factors seem to influence the frequencies of different ELDs and the strength of their determinants across countries, but they do not change the essence of decision making.

Locating whiteness in the academic production of "I Philosophy" in and of time and place

This review will critically evaluate two recent texts by white academics working across disciplines of cultural studies, history and anthropology and published by UNSW Press, which share a focus on the relationship between Aboriginality, Philosophy, Place and Time in Australia. I write from the position of a queer white academic committed to engaging politically and intellectually with the challenge of Indigenous sovereignties in this place while also aware that my position as a middle class white woman and intellectual imposes limits on what it is possible for me to know about Indigenous epistemologies (see Moreton-Robinson, 2000). In the course of this review I will demonstrate how anthropology's tendency to fix its objects of study within a circumscribed space of 'difference' limits the capacity of texts produced within this discipline to account for racialized struggles over sovereignty. While these struggles are equally embedded in the ethnographic context and the nation's constitution and political institutions, we will see that Muecke and Bird Rose confront problems in analysing the relationship between the intimate space of the 'field', in which one's research subjects quickly become one's 'friends' and/or 'classificatory kin'—on one hand—and the public space of the nation within which statements about Aboriginality by white academics circulate and are vested with an authority that escapes individual intentions and control—on the other.