Background End-of-life medical decision-making is becoming more frequent. Reliable empirical data on what doctors do and how they decide in real end-of-life situations is scarce.

Aims The project aims to

• give an up-to-date assessment of the main features of medical end-of-life decision making practices in the German-speaking part of Switzerland;

• evaluate the changes in end-of-life decision making in the German-speaking part of Switzerland since 2001.

Methods We sampled approximately 5000 randomly selected deaths in the German-speaking part of Switzerland reported to the Swiss Federal Office of Statistics between July 31, 2013 and January 31, 2014. Physicians who signed the selected death certificates were sent a questionnaire.

Results The response rate was 63%. The first results indicate that the proportions of medical end-of-life decisions have not changed dramatically over the last decade. However compared to 2001 there was a remarkable increase of non-treatment decisions and terminal sedation. Although the rate of discussed decisions among competent patients slightly decreased, it can still be considered as high.

Discussion This is the first analysis of trends in an important field of medical decision-making in a German-speaking area. The results confirm the characteristics found in the first study in 2001 and implicate that non-treatment decisions are an important practice in Switzerland.

Conclusion These results on prevalence and trends of end-of-life decision-making of physicians in Switzerland contribute to an evidence-based discussion of a highly emotional topic.