GPs and end of life decisions : views and experiences

Abstract

The views and experiences of GPs with respect to end of life (EoL) care are seldom addressed. The aim of this article is to better understand this aspect of care. A cross-sectional survey of all doctors in the country was designed and set up. The overall response was 396 (39.7%), 160 of which were GPs. 28.7% of GPs received no formal training in palliative medicine. 89.8% of respondents declared that their religion was important in EoL care. 45.3% agreed with the right of a patient to decide whether or not to hasten the EoL. 70.5% agreed that physicians should aim to preserve life. 15% of GPs withdrew or withheld treatment in the care of these patients. 41.1% had intensified analgesia at EoL. 7.5% had sedated patients at EoL. Lastly, 89.1% GPs would never consider euthanasia. Significant correlation (p< 0.05) was observed between considering euthanasia, using sedation, importance of religion and patients’ rights in EoL. A thematic analysis of comments highlighted the importance of the topic and feeling uncomfortable in EoL care. In conclusion there needs to be more training in palliative care. GPs believe in preserving life, would not consider euthanasia but do not shun intensification of analgesia at the end of life. There might be some misunderstanding with respect to the role of sedation at the EoL. GPs need legal and moral guidance in EoL care, in the absence of which, their religion is used as a guide.