Most difficult consultation N = 449* (%) | ||
---|---|---|
Patient characteristics | 79.7 | |
No short-term life-threatening disease (e.g. accumulation of age-related health problems, chronic diseases, invalidity) | 18.8 | |
Communication was difficult (e.g. coma, confused, not clear, aphasic) | 18.4 | |
Psychiatric problems | 13.5 | |
Ambivalence towards death wish | 12.8 | |
Patient was demanding, angry | 11.6 | |
Dementia, cognitive decline | 10.7 | |
Patient was young | 7.8 | |
Psychosocial problems (e.g. tired of living, loneliness) | 5.8 | |
Time pressure due to medical state | 2.6 | |
Assessment of the due care criteria | 41.0 | |
Suffering hard to assess due to the situation of the patient | 11.8 | |
An early consultation | 8.9 | |
Mental competence hard to assess | 6.6 | |
Unbearable suffering hard to imagine | 5.8 | |
Treatment options hard to define | 5.6 | |
Suffering hard to asses due to lack of information (from patient/file/physician) | 4.4 | |
Hard to assess whether the request was voluntary | 1.5 | |
Patient’s relatives | 26.3 | |
Relatives aren’t ready for/have problems with the EAS | 7.5 | |
Relatives exert pressure on the physician | 5.6 | |
Problems within the family (not related to the EAS e.g. grief, no contact with children, family lives far away) | 4.6 | |
Patient wants EAS together with partner | 2.2 | |
Family cannot handle the care for the patient | 2.2 | |
Patient provides care for children/partner | 2.2 | |
Pressure from relatives on patient | 0.8 | |
Health professionals | 23.4 | |
Pressure/not understanding doubts or judgement of the SCEN physician | 8.9 | |
Doubting/unclear/unprepared attending physician | 6.1 | |
Attending physician does not want to perform the EAS | 2.4 | |
Attending physician was influenced by the patient and relatives | 2.3 | |
Suboptimal care (e.g. too little care, not in place wished for, futile treatment) | 2.3 | |
Attending physician already promised to perform the EAS | 1.9 | |
Bad contact between attending physician and patient | 1.7 | |
(Part of) health professionals are against EAS/agitation among health professionals | 1.2 | |
Attending physician expected more counseling from the SCEN physician | 1.0 | |
Attending physician seemed to want consultation/EAS earlier than patient | 0.6 | |
Other aspects | 13.4 | |
An earlier SCEN physician judged differently | 2.9 | |
Little experience of SCEN physician with disease | 2.6 | |
Resistance of SCEN physician concerning a specific case | 2.6 | |
Situation was moving | 1.9 | |
Attending physician was also a SCEN physician | 0.8 | |
SCEN physician acted awkward him/herself | 0.6 | |
Questionable whether the second physician was independent | 0.6 | |
Consultation with other SCEN physician necessary | 0.6 | |
Other | 1.5 |