Caring for the terminally ill: what do the doctors think?

Abstract

Patients’ perception of end-of-life events varies with cultural norms and values, and expectations may differ from clinicians’ practice and actions. In contemporary practice, conflict of ideas often results in patients discharging themselves against medical advice. Clinicians (67) that have been in medical practice for at least five years at the main tertiary hospital in Benin City were interviewed with a semi-structured questionnaire. The main outcome measured was clinicians’ attitude towards caring for the terminally ill patients and physician assisted suicide (PAS). The mean age of the clinicians was 36.8 9± 7.57, 11 females and 56 males. Twenty-six clinicians (40%) do not routinely record in the case notes details of their discussion on prognosis with their patients. Forty-one (62.1%) clinicians will not support life while patients are on palliative care, while 49/66 (74.2%) will transfuse their patients with blood. Thirteen (31.7%) will not support life, and will not transfuse blood. Fifty-seven (85.1%) clinicians will not support euthanasia, 8 of the 9 physicians who will support PAS are males, while 6 of the 9 clinicians that will grant patient's request for PAS are gynecologists. All (17) clinicians in Internal Medicine specialty will not support PAS. while 51/67 (77.3%) clinicians are of the opinion that patients should be routinely informed of the prognosis of their disease. Documentation of physician-patients’ interactions is poor amongst clinicians. Most will not support life and physician-assisted suicide for the terminally ill patients. However, in clinical practice most will transfuse their patients on palliative care with blood and give other life support treatment; an apparent dissociation between what clinicians think and what is practised.