Does Decision-making in End-of-life Care Differ Between Graduating Medical Students and Experienced Physicians?

: Alminoja A, Piili RP, Hinkka H, Metsänoja R, Hirvonen O, Tyynelä-Korhonen K, Kaleva-Kerola J, Saarto T, Kellokumpu-Lehtinen PLI, Lehto JT

Publisher: INT INST ANTICANCER RESEARCH

: 2019

: In Vivo

: IN VIVO

: 33

: 3

: 903

: 909

: 7

: 0258-851X

: 1791-7549

DOI: https://doi.org/10.21873/invivo.11557

: http://iv.iiarjournals.org/content/33/3/903

Background/Aim: Appropriate decision-making in end-of-life (EOL) care is essential for both junior and senior physicians. The aim of this study was to compare the decision-making and attitudes of medical students with those of experienced general practitioners (GP) regarding EOL-care. Materials and Methods: A questionnaire presenting three cancer patient scenarios concerning decisions and ethical aspects of EOL-care was offered to 500 Finnish GPs and 639 graduating medical students in 2015-2016. Results: Responses were received from 222 (47%) GPs and 402 (63%) students. The GPs withdrew antibiotics (p<0.001) and nasogastric tubes (p=0.007) and withheld resuscitation (p<0.001), blood transfusions (p=0.002) and pleural drainage (p<0.001) more often than did the students. The students considered euthanasia and assisted suicide less reprehensible (p<0.001 in both) than did the GPs. Conclusion: Medical students were more unwilling to withhold and withdraw therapies in EOL-care than were the GPs, but the students considered euthanasia less reprehensible. Medical education should include aspects of decision-making in EOL-care.