What Do Medical Oncologists Want for Themselves at The End-of-Life? Analysis of Go Wish Cards Game.

Abstract

Discussing end-of-life (EoL) values and priorities remains challenging in oncology, despite its relevance for person-centered and dignified care. To explore clinical oncologists' and oncology residents' perceptions of personal EoL values and priorities through their experience with the Go Wish Cards Game (GWCG), and to understand their reflections on the role and applicability of this tool in oncologic practice. This qualitative study included 49 participants (31 clinical oncologists and 18 oncology residents) from two Brazilian cancer centers. In individual sessions, participants selected and discussed the most meaningful GWCG cards, completing the exercise from the perspective of their own EoL values and priorities. Transcripts were analyzed using Bardin's content analysis method to identify emerging themes. The most frequently chosen cards differed between groups: clinical oncologists prioritized "Having family and friends nearby," while oncology residents emphasized "Relief from pain and shortness of breath." Five thematic categories emerged: symptom control and physical comfort; dignity and autonomy; relationships and social/family support; spirituality and existential issues; and communication, legacy, and reflexivity. The GWCG fostered ethical and existential reflection, enhanced awareness of personal values, and demonstrated its potential as an educational and sensitizing tool in oncologic care. The use of the GWCG promoted reflection on participants' own EoL values and priorities, facilitating dialogue on sensitive topics. This self-reflective process can enhance participants' sensitivity to understanding what is essential to patients. Thus, the GWCG may contribute to more humanized, reflective, and values-aligned clinical practices in oncology.