A national survey of anaesthetists' preferences for their own end of life care

Abstract

Objectives: To develop a valid questionnaire to describe individual views, wishes and preferences for end of life care and report UK anaesthetists personal perspectives. Methods:The bigconversations questionnaire was developed by modifying an existing framework for end of life discussions. An online cross-sectional survey of UK anaesthetists was then conducted using the questionnaire in January 2019. Results:The bigconversations questionnaire was validated as measuring the important aspects of end of life care by an expert panel and was found to have moderate test-retest reliability.Responses were received from 760/1,913 (40%) of those invited to take part. 698/760 (92%) of respondents wished to be well informed about their condition and prognosis and 518/760 (68%) wanted to be heavily involved in decision making about their health. 639/760 (84%) respondents would choose to forego treatment aimed at prolonging life should that life be of poor quality. The desire to spend time with family was a theme which arose from the qualitative analysis. Conclusion:This study provides the first systematic description of UK doctors, specifically anaesthetists, personal preferences for end of life care. Broad trends were identified: to be well informed; to avoid high-intensity medical treatments if terminally unwell; to spend remaining time with family and friends; and to be symptom free and well cared for. However, a substantial minority expressed different, indeed opposite, opinions. This variation highlights that good quality end of life care must be driven by discussion of an individual's values, wishes and preferences.