How do intensive care physicians wish to die? A cross-sectional study on end-of-life preferences and the role of palliative care.

INTRODUCTION

Intensive care physicians are uniquely positioned to understand the benefits and burdens of life-prolonging treatments. This study aimed to examine the personal end-of-life preferences of intensive care physicians when facing a hypothetical incurable terminal illness and to evaluate the role of palliative care within these preferences.

MATERIALS AND

METHODS

In this descriptive cross-sectional study, a 17-item survey instrument (12 close-ended and 5 open-ended questions) was administered electronically to anesthesiology and reanimation specialists working in public and private hospitals in Istanbul. Quantitative data were analyzed using descriptive statistics, while qualitative responses were evaluated through thematic analysis. Content validity of the questionnaire was assessed using established content validity index methodology.

RESULTS

A total of 296 physicians participated (response rate: 28.8%). The mean age was 43.79 ± 7.54 years, and the mean duration of specialist practice was 12.34 ± 9.44 years. Refusal rates for aggressive life-prolonging interventions exceeded 70% across most modalities, with the highest refusal observed for cardiopulmonary resuscitation (88.5%). Only 0.7% of respondents indicated a preference to spend the end of life in a palliative care unit. Among physicians who had previously made end-of-life decisions for first-degree relatives, only 1.3% reported utilization of palliative care services.

DISCUSSION: Intensive care physicians strongly favor comfort-focused and palliative-oriented approaches for themselves at the end of life. However, the extremely low preference for palliative care units highlights a substantial gap between personal values and the current healthcare system. Strengthening palliative care integration, education, and policy frameworks is urgently needed.