Mroz Sarah, Daenen Frederick, Dierickx Sigrid, Mortier Freddy, De Panfilis Ludovica, Downar James, Lapenskie Julie, Anderson Koby, Skold Anna, Campbell Courtney, Campbell Toby C, Feeney Rachel, Willmott Lindy, White Ben P, Chambaere Kenneth, Deliens Luc
End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.
Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Palliat Med. 2025 Feb;39(2):266-276. doi: 10.1177/02692163241300853. Epub 2024 Dec 13.
Physicians have significant influence on end-of-life decisions. Therefore, it is important to understand the connection between physicians' personal end-of-life care preferences and clinical practice, and whether there is congruence between what they prefer for themselves and for patients.
Study to what extent physicians believe their personal end-of-life preferences impact their clinical practice and to what extent physicians' personal treatment option preferences differ from what they prefer for their patients.
A cross-sectional survey was conducted from May 2022 to February 2023.
SETTING/PARTICIPANTS: Eight jurisdictions: Belgium, Italy, Canada, USA (Oregon, Wisconsin, and Georgia), and Australia (Victoria and Queensland). Three physician types were included: general practitioners, palliative care physicians, and other medical specialists.
We analyzed 1157 survey responses. Sixty-two percent of physicians acknowledge considering their own preferences when caring for patients at the end of life and 29.7% believe their personal preferences impact the recommendations they make. Palliative care physicians are less likely to consider their own preferences when caring for and making recommendations to patients. Congruence was found between what physicians prefer for patients and themselves with cardiopulmonary resuscitation considered "not a good option for both" by 99.1% of physicians. Incongruence was found with physicians considering some options "not good for the patient, but good for themselves"-palliative sedation (8.3%), physician-assisted suicide (7.0%), and euthanasia (11.6%).
Physicians consider their own preferences when providing care and their preferences impact the recommendations they make to patients. Incongruence exists between what physicians prefer for themselves and what they prefer for patients.
医生对临终决策有重大影响。因此，了解医生个人的临终护理偏好与临床实践之间的联系，以及他们对自己和患者的偏好是否一致非常重要。
研究医生认为其个人临终偏好对临床实践的影响程度，以及医生个人的治疗选择偏好与他们为患者所偏好的治疗选择之间的差异程度。
于2022年5月至2023年2月进行了一项横断面调查。
地点/参与者：八个司法管辖区：比利时、意大利、加拿大、美国（俄勒冈州、威斯康星州和佐治亚州）以及澳大利亚（维多利亚州和昆士兰州）。纳入了三种类型的医生：全科医生、姑息治疗医生和其他医学专科医生。
我们分析了1157份调查问卷回复。62%的医生承认在为临终患者提供护理时会考虑自己的偏好，29.7%的医生认为他们的个人偏好会影响他们给出的建议。姑息治疗医生在为患者提供护理和给出建议时考虑自己偏好的可能性较小。在医生为患者和自己所偏好的选择方面发现了一致性，99.1%的医生认为心肺复苏“对双方都不是一个好选择”。发现存在不一致的情况，即医生认为某些选择“对患者不好，但对自己好”——姑息性镇静（8.3%）、医生协助自杀（7.0%）和安乐死（11.6%）。
医生在提供护理时会考虑自己的偏好，且他们的偏好会影响对患者给出的建议。医生对自己和患者的偏好之间存在不一致。
