What do physicians want at the end? An international qualitative study on physicians’ personal end-of-life preferences and what influences them

Background: Physicians play a key role in end-of-life decision-making. As research suggests a connection between physicians’ personal end-of-life preferences and their clinical practice, it is important to understand what physicians want for themselves at the end of life and what has shaped their pr...

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Main Authors: Sarah Mroz, Frederick Daenen, Sigrid Dierickx, Freddy Mortier, Ludovica De Panfilis, Luca Ghirotto, Toby Campbell, Kenneth Chambaere, Luc Deliens
Format: Article
Language:English
Published: SAGE Publishing 2025-07-01
Series:Palliative Care and Social Practice
Online Access:https://doi.org/10.1177/26323524251351349
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author Sarah Mroz
Frederick Daenen
Sigrid Dierickx
Freddy Mortier
Ludovica De Panfilis
Luca Ghirotto
Toby Campbell
Kenneth Chambaere
Luc Deliens
author_facet Sarah Mroz
Frederick Daenen
Sigrid Dierickx
Freddy Mortier
Ludovica De Panfilis
Luca Ghirotto
Toby Campbell
Kenneth Chambaere
Luc Deliens
author_sort Sarah Mroz
collection DOAJ
description Background: Physicians play a key role in end-of-life decision-making. As research suggests a connection between physicians’ personal end-of-life preferences and their clinical practice, it is important to understand what physicians want for themselves at the end of life and what has shaped their preferences. Objective: To explore what physicians have considered for their end-of-life preferences, including life-sustaining and life-shortening practices, and their perceptions of the socio-cultural factors that influence their preferences. Design: Qualitative study using in-depth interviews. Methods: Forty-five interviews were conducted from January to November 2022 using a semi-structured interview guide. Participants included three types of physicians: general practitioners, palliative care physicians, and other medical specialists in Belgium (Flanders), Italy, and the United States (Wisconsin). Data collection and analysis were informed using the reflexive thematic analysis approach. Audio recordings were transcribed verbatim and NVivo 14 was used for coding and analysis. Consolidated criteria for reporting qualitative research (COREQ) were followed. Results: We found physicians, particularly those in palliative care, have reflected on their end-of-life preferences and have ideas about what constitutes a good death and what they hope to avoid. Most physicians prefer to avoid aggressive and life-prolonging treatment, physical and mental suffering, and being a burden. They prioritize being in a peaceful environment and communication with loved ones. Various factors influence preferences including cultural, social, and religious beliefs, and legislative environment, but most significant are the deaths of loved ones and clinical practice. Death and dying become normalized the more they are reflected upon and discussed, and this process can also provide personal growth which helps physicians provide better care to patients and families. Conclusion: Physicians have reflected on their end-of-life preferences and prefer a peaceful end of life without aggressive and life-prolonging treatment. Physicians’ views on end-of-life practices are influenced by evolving cultural and societal norms and legal and ethical factors.
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spelling doaj-art-2e54faca034f4424ac8b9b2b7979c3f32025-08-20T03:31:24ZengSAGE PublishingPalliative Care and Social Practice2632-35242025-07-011910.1177/26323524251351349What do physicians want at the end? An international qualitative study on physicians’ personal end-of-life preferences and what influences themSarah Mroz0Frederick Daenen1Sigrid Dierickx2Freddy Mortier3Ludovica De Panfilis4Luca Ghirotto5Toby Campbell6Kenneth Chambaere7Luc Deliens8Department of Public Health and Primary Care, Ghent University, BelgiumDepartment of Family Medicine and Chronic Care, Vrije Universiteit Brussel, BelgiumDepartment of Family Medicine and Chronic Care, Vrije Universiteit Brussel, BelgiumBioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent University, BelgiumIRCCS Azienda Ospedaliero-Universitaria di Bologna, ItalyUnità Sanitaria Locale – IRCCS di Reggio Emilia, ItalyUniversity of Wisconsin School of Medicine and Public Health, Madison, WI, USADepartment of Public Health and Primary Care, Ghent University, BelgiumDepartment of Family Medicine and Chronic Care, Vrije Universiteit Brussel, BelgiumBackground: Physicians play a key role in end-of-life decision-making. As research suggests a connection between physicians’ personal end-of-life preferences and their clinical practice, it is important to understand what physicians want for themselves at the end of life and what has shaped their preferences. Objective: To explore what physicians have considered for their end-of-life preferences, including life-sustaining and life-shortening practices, and their perceptions of the socio-cultural factors that influence their preferences. Design: Qualitative study using in-depth interviews. Methods: Forty-five interviews were conducted from January to November 2022 using a semi-structured interview guide. Participants included three types of physicians: general practitioners, palliative care physicians, and other medical specialists in Belgium (Flanders), Italy, and the United States (Wisconsin). Data collection and analysis were informed using the reflexive thematic analysis approach. Audio recordings were transcribed verbatim and NVivo 14 was used for coding and analysis. Consolidated criteria for reporting qualitative research (COREQ) were followed. Results: We found physicians, particularly those in palliative care, have reflected on their end-of-life preferences and have ideas about what constitutes a good death and what they hope to avoid. Most physicians prefer to avoid aggressive and life-prolonging treatment, physical and mental suffering, and being a burden. They prioritize being in a peaceful environment and communication with loved ones. Various factors influence preferences including cultural, social, and religious beliefs, and legislative environment, but most significant are the deaths of loved ones and clinical practice. Death and dying become normalized the more they are reflected upon and discussed, and this process can also provide personal growth which helps physicians provide better care to patients and families. Conclusion: Physicians have reflected on their end-of-life preferences and prefer a peaceful end of life without aggressive and life-prolonging treatment. Physicians’ views on end-of-life practices are influenced by evolving cultural and societal norms and legal and ethical factors.https://doi.org/10.1177/26323524251351349
spellingShingle Sarah Mroz
Frederick Daenen
Sigrid Dierickx
Freddy Mortier
Ludovica De Panfilis
Luca Ghirotto
Toby Campbell
Kenneth Chambaere
Luc Deliens
What do physicians want at the end? An international qualitative study on physicians’ personal end-of-life preferences and what influences them
Palliative Care and Social Practice
title What do physicians want at the end? An international qualitative study on physicians’ personal end-of-life preferences and what influences them
title_full What do physicians want at the end? An international qualitative study on physicians’ personal end-of-life preferences and what influences them
title_fullStr What do physicians want at the end? An international qualitative study on physicians’ personal end-of-life preferences and what influences them
title_full_unstemmed What do physicians want at the end? An international qualitative study on physicians’ personal end-of-life preferences and what influences them
title_short What do physicians want at the end? An international qualitative study on physicians’ personal end-of-life preferences and what influences them
title_sort what do physicians want at the end an international qualitative study on physicians personal end of life preferences and what influences them
url https://doi.org/10.1177/26323524251351349
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