Medical end-of-life decision (ELD)

A medical end-of-life decision is made by the patient's attending physician, usually after discussion with colleagues and in consultation with the patient and his/her relatives.

In the End of Life Survey, the following medical end-of-life decisions are distinguished, in ascending order from least invasive to most invasive:
• decision not to initiate and/or to discontinue treatment (‘NIS’) in which the physician considered hastening the patient’s end of life.
• decision to intensify pain and/or symptom management (‘PSB’) in which the physician considered hastening the patient’s end of life.
• decision to intensify pain and/or symptom management (‘PSB’) in which the physician partly considered hastening the patient’s end of life.
• decision not to initiate and/or to discontinue treatment (‘NIS’) in which the physician explicitly intended to hasten the patient’s death.
• prescribe, dispense or administer a drug with the explicit aim of hastening the patient’s death (‘administer drug’)
This group can be sub-classified into euthanasia, assisted suicide, and life-ending acts without an explicit request.
If the physician indicated multiple decisions, the death is classified by the most consequential decision.

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