Do internists know what limitation of therapeutic effort means?

To ascertain whether internists know what limitation of therapeutic effort (LTE) means and whether training in palliative care affects this understanding. A survey was administered to Spanish internists on their knowledge of LTE and training in palliative care. A total of 273 respondents completed the survey (mean age, 42±12 years), 80.2% of whom were associates. Some 23.8% of the respondents identified the complete definition of LTE. The most frecuently selected responses were «not starting an active treatment»(85.0%) and «withdrawing an active treatment» (65.9%). Forty-three percent of the respondents lacked training in palliative care, 73.3% considered their level of understanding to be good or very good, 62.3% stated that they became anxious when addressing planning for end-of-life care with a patient, and 81.3% stated that they had experienced some conflict with their LTE decisions. Only 1 of every 4 internists knew the proper definition of LTE, with no association with level of training in palliative care.