A post-mortem population survey on foetal-infantile end-of-life decisions: a research protocol

Abstract

The physician sends the questionnaire, together with a separate letter containing patient identification details to the lawyer and sends the certificate to the official death certificate agency. Because the latter sends patient identification details of death certificates for stillbirths to the lawyer, the lawyer can then determine whether a questionnaire has already been received for that death and notify the Flemish agency for Care and Health via email. Fig. 2 Fig. 2 Schematic overview of the parallel procedure in the ten biggest maternity wards Improving response rates To increase response, we follow the Total Design Method (TDM) [30]. [...]physicians will receive a maximum of three follow-up postal mailings. Delays in the processing of death certificates can reach up to 4 months before the questionnaire is sent to the physician in the first method [29]. [...]a recall bias cannot be excluded. Implications for future research and practice Regular repetition of this study in the future is needed in order to monitor and evaluate changes in end-of-life practices in the foetal-infantile group. Because this study design allows application in other countries, we recommend international comparative studies to provide us with better insight into foetal-infantile end-of-life practices and incidence rates so that international foetal and neonatal care at the end of life can be optimised.