Doctors’ willingness to give honest answers about end-of-life practices: a cross-sectional study

Abstract

ObjectivesWe aimed to (1) evaluate the extent to which doctors in New Zealand would be willing to answer honestly questions about their care of patients at the end of their lives and (2) identify the assurances that would encourage this. Results were compared with findings from a previous pilot study from the UK.DesignSurvey study involving a mailed questionnaire.SettingNew Zealand hospital and community-based medical care settings.ParticipantsThe questionnaire was mailed to a random sample of 800 doctors in New Zealand who were vocationally registered with the Medical Council of New Zealand in disciplines involving caring for patients at the end of their lives.Primary and secondary outcome measuresWillingness to provide honest answers about various aspects of end-of-life care; assurances that might increase willingness to provide honest answers to questions about end-of-life practices.ResultsCompleted questionnaires were returned by 436 doctors. The majority of respondents (59.9–91.5%) indicated willingness to provide honest answers to such questions. However, more than a third of doctors were unwilling to give honest answers to certain questions regarding euthanasia. These results are comparable with the UK data. Complete anonymity was the assurance most likely to encourage honest answering, with most of the respondents preferring the use of anonymous written replies. Respondents were less reassured by survey endorsements from regulatory bodies. Themes in free comments included the deterrent effect of medicolegal consequences, fear of censure from society, peers and the media and concerns about the motivations and potential uses of such research.ConclusionsMany New Zealand doctors were willing to give honest answers to questions about end-of-life practices, particularly if anonymity was guaranteed; others, however, expressed doubts or indicated that they would not be willing to provide honest answers to questions of this sort.

The euthanasia debate: synthesising the evidence on New Zealander's attitudes

“…The results of studies involving NZ health professionals are similar to those in other countries (Sheahan 2016;Oliver et al 2017). Findings relating to healthcare professionals' views must be interpreted in light of research that suggests one third of NZ doctors may not be willing to answer honestly when asked about EAD because of perceived legal implications, disapproval from others, and suspicion about the intent of the research (Merry et al 2013).…”

“…Two studies provided respondents with medical treatment options and asked lay participants to decide on the most appropriate course of action for the doctor, which assumed a certain level of knowledge about such practices (Mitchell and Owens 2004;Rae et al 2015). Social norms may also influence doctors responses to questions about EAD (Merry et al 2013). Bias may also appear in authors' interpretation and reporting of results.…”

Physician-Assisted Dying: Acceptance by Physicians Only for Patients Close to Death

“…To avoid bias the questionnaire was anonymous, asking only about gender, age, occupation, and religiousness. This should ensure honest answers [ 33 ]. However, EOL decision making is a controversial topic and because of the crucial role of the physicians there might still be a certain bias to give socially desirable answers.…”

Medical end-of-life decision-making in a small resource-poor Caribbean country: a mortality follow-back study of home deaths

“…For instance, our obtained sample could be biased toward people who died with a predictable end-of-life trajectory, and responses could have been biased to general practitioners that have an interest in the field of palliative medicine. Also, the sensitive nature of questions could have affected physician self-reporting, as they may have felt they could not be truthful about their own endof-life practices (27). Additionally, selection bias due to sampling cannot be ruled out as incomplete information on some death certificates (for example, decedent age or sex were missing or the certifying general practitioners' name or contact details were illegible) excluded such cases.…”