Objective:

The qualitative interview study analyses informal knowledge structures of nurses and physicians regarding “age” and “cost” as factors influencing treatment decisions at the end-of-life and as a basis of forming ethical opinions.

Methods:

We used spontaneous statements on “age” and “cost” that were not inquired in a context of studying ageism or rationing. A content analysis was carried out on these statements applying both qualitative and quantitative steps.

Results

The study shows that the factor “age” is much more frequently mentioned as being decisive in therapy decisions at the end-of-life than the factor “cost”. We found indications of potentially unequal treatment and over-treatment of patients at the end-of-life. The data support the assumption that treatment decisions rely on rather informal, non-institutionalized procedures.

Conclusion

Giving the processes of treatment decisions more explicit structure might reduce the risks of unequal treatment and over-treatment and might contribute to results that are ethically better justified.