Facing death in clinical practice: a view from physicians in Mexico.

OBJECTIVE

Physicians' decisions and actions, once they know that their patients' death is inevitable, will influence how patients are going to live their last moments. The purpose of the present study was to explore the views of physicians about death in their clinical practices.

METHODS

Physicians who work at four high-specialty public hospitals and two private hospitals in Mexico City provided responses to the Physicians' Views about Death Questionnaire, which was developed for this study.

RESULTS

Four hundred thirteen physicians were surveyed. The majority treat terminally ill patients (73.3%), but only 28% received training regarding death. Nearly half of the physicians reported a personal formative experience related to death which, together with the experience of being exposed to terminally ill patients, appear to be the manner in which the majority of physicians learn to deal with death. The great majority of participants (90.6%) would personally like to know the truth if they were going to die. Younger physicians, those with <6 years of medical practice, those with no death-related personal formative experience, no death-related academic training, and no experience treating terminally ill patients were most likely to avoid telling patients about their imminent death.

CONCLUSIONS

Death is an important topic for physicians in Mexico. There is a relation between lack of information, experience, and formal training, and the withholding of information from dying patients. This suggests a possible value for interventions to enhance and develop coping skills for professionals who deal with end-of-life situations.