gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Prevalence of patients decrees in a neurosurgical unit – a survey study

Meeting Abstract

  • Daniela Müller - Universitätsklinikum Essen, Essen, Deutschland
  • Nicolai El Hindy - Universitätsklinikum Essen, Essen, Deutschland
  • Bernadette Kleist - Essen, Deutschland
  • Ulrich Sure - Essen, Deutschland
  • Oliver Müller - Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.19.01

doi: 10.3205/17dgnc492, urn:nbn:de:0183-17dgnc4927

Published: June 9, 2017

© 2017 Müller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: The patient’s autonomy is of utmost importance among the four principles of ethics in medicine according to Beauchamp and Childess. The public interest has focused on this topic in recent years. This study is to assess the prevalence of decrees in patients admitted to a single neurosurgical unit and, furthermore, to evaluate the patients’ understanding of the content of their decrees.

Methods: All patients admitted to the neurosurgical department were asked for their participation in the survey between November 2014 and September 2015. A total of 500 patients approved and was included for study reasons. 482 completed surveys could be evaluated for further analysis. Approval from the local ethics research committee was obtained prior to inclusion.

Results: Of 482 patients, 210 had a written decree (43.6%). The prevalence increased with higher age of life (significant correlation with age >65years; Chi2(1)=49.46; p<0.001). The likelihood that patients completed a decree was significant higher in patients older than 65y (OR 3.86). Patients that had a decree were most likely to have a medical power of attorney as well (86.2%). The underlying diagnosis did not influence the prevalence of a decree. 30% of the patients were either not informed about the content of their decree or had transferred the responsibility for medical decisions onto the treating physicians or their relatives, respectively. 49.3% refused life supporting treatments, but only 10% specified these restrictions in regard of ventilation and resuscitation.

Conclusion: The importance of patient decrees has been intensely debated in the media and the public, and the incidence especially in older patients is higher than expected in our cohort. Compared to the frequency of a completed organ donor cards (28%) the incidence is twice as high. Yet, only the minority of patients has declared their will in detail that will be sufficient for therapeutic decision making. Therefore, we may suggest from our data that a better explanation about the meaning and content of a patient decree is needed for the insert your text.