"End-of-Life Care Is as Important as Any Other Lifesaving Task": A Scandinavian Survey Study.

Abstract

Intensive care physicians often provide end-of-life (EOL) care in the intensive care units (ICUs). However, knowledge about the physicians' role and confidence in EOL care after the decision to withdraw life-sustaining therapy is unknown. This study aimed to explore the confidence and the self-perceived role of specialized ICU physicians in performing EOL care. Following criteria-based sampling, a questionnaire was sent to ICU physicians in Iceland, Sweden, Norway, Finland, and Denmark. Questions included: (1) Background information and existing guidelines, (2) Physicians' confidence in EOL care in ICUs, and (3) Self-perceived role in EOL care. The questionnaire collected both quantitative and qualitative data, which were subsequently analyzed separately. A total of 178 ICU physicians answered the questionnaire. Most physicians (66%) felt very confident performing EOL care. Responses to the open-ended qualitative questions emphasized that ICU physicians regarded EO care as a central professional responsibility, marked by personal presence, active support for patients and families, and attention to individual needs. They reported the value of transparent communication, thorough preparation for treatment withdrawal, and accommodation of personal, cultural, and religious preferences. Participants highlighted the importance of individualized transfer decisions while also emphasizing the need for adaptable EOL guidelines and enhanced training, particularly for residents. Our study showed that Scandinavian ICU physicians felt very confident in performing EOL care and recognized their unique role and responsibility in delivering ICU EOL care. This study surveyed ICU physicians in Nordic countries concerning perceptions and confidence for end care in their ICU clinical practice. The responses indicated that the survey responders were quite confident in how they manage this group of cases in the ICU.