Consciousness survey of doctors and nurses belonging to the Tokuyama medical association on end-of-life care

Abstract

As the elderly population in Japanese increases, the practice of advance care planning (ACP) is a necessity in clinical practice. It is an approach different from the past medical practices which prioritized life-saving above all, and there are cases where some medical professionals, especially doctors, refuse to practice it. In order to explore how to expand discussions for decision-making that respects the wishes of patients and ultimately extend the conversation to the community, I investigated member doctors and nurses of Tokuyama Medical Association, on their consciousness of end-of-life care. While the attitude towards the end-of-life for patients suffering from incurable chronic diseases, cancer and senility was positive：it was less so for those who lack the ability of self-care and or orally ingest. Regarding palliative care, 80% of the nurses and 70% of the doctors considered it a priority and necessary for terminally ill patients. 20% of doctors felt compelled to provide continual medication to avoid possible legal ramifications leading to lawsuits. Moreover, a large percentage of doctors and nurses, especially women, felt that terminally ill patients received overmedication. Furthermore, during medical engagements like this, 50% of doctors and nurses felt physical burden and 70-80% mental burden. Although 70-80% of doctors and nurses have experienced the practice of ACP, many of them wanted to use POLST for patients. The practice of ACP is not just for the patient but also for the medical profession related to end-of-life care but is also needed in accordance with the practice of medical treatment of the intentions for patients.