Much of the general public doesn’t experience death very often. Many doctors, on the other hand, do. Researchers with the End-of-life Care Research Group in Belgium wondered how this intimate knowledge shaped physicians’ wishes for their own inevitable ends, and how their desires differ with those of non-physicians.
The researchers interviewed 45 doctors – fifteen each from Italy, Belgium, and the United States. The interviewees included general practitioners, palliative care physicians, and other medical specialists with a high likelihood of seeing patients near death.
“Physicians often cited the elements of a good death as being at home or in hospice, anticipating death, loved ones nearby, enough time for goodbyes, not suffering, pain and symptoms controlled, spiritual and practical affairs in order, a clear mind, and autonomy and dignity preserved,” the authors reported in the journal Palliative Care and Social Practice.
Many physicians were also aware that their own preferences could change closer to the end, having witnessed their own patients’ plans fluctuate at death’s door.
“So many patients I’ve run into change their mind,” a palliative care physician from Wisconsin told the researchers. “Over time you can get acclimated to new baselines you never thought that you could.”
As one would expect, doctors’ clinical experience heavily factored into their wishes for how they’d like to die, but even more impactful were the deaths of loved ones. A family member’s experience resonated much more than a patient’s.
Doctors’ views on dying were also sharply affected by witnessing undesirable deaths. Seeing patients with uncontrolled symptoms or severe pain, being on a ventilator long term, receiving futile treatments, being alone, being dependent on others for care, and being confused or cognitively impaired stuck in physicians’ psyches.
Perhaps this was why most physicians expressed the desire to avoid life-prolonging measures such as cardiopulmonary resuscitation, artificial nutrition and hydration, and mechanical ventilation. Prior studies suggest that this is a key differentiator between doctors and members of the general public. Personally aware of the burdens of life-sustaining treatments, physicians are more likely to forgo them. Near the end, they tend to opt for quality of life over longevity at any cost.
Source: Mroz S, Daenen F, Dierickx S, et al. What do physicians want at the end? An international qualitative study on physicians’ personal end-of-life preferences and what influences them. Palliative Care and Social Practice. 2025;19. doi:10.1177/26323524251351349