PROPEL: Physician Reported Preferences for End-of-life Decisions in Europe, North America and Australia

11-2019 to 11-2023

Background
Physicians play a key role in end-of-life decisions, which are of increasing importance as the global aging population expands and people live longer with extended illnesses. In developed countries, half of all deaths are preceded by at least one end-of-life decision including, withholding and withdrawing treatment, palliative sedation or assisted dying, among others. There is evidence to suggest a connection between physicians’ reflection on personal preferences and their own clinical practice. However, there is a lack of knowledge on physicians’ ELD preferences and how those preferences impact their clinical decision making. Exploring this link is crucial as physicians have significant influence on patients and health care systems. Gaining a better understanding will require exploring various factors including religious, sociocultural and jurisdictional influences. As end-of-life options are expanding around the world, exploring these issues within a cross-cultural context will allow for international comparison and knowledge sharing that will address complex moral and clinical issues related to end-of-life care. 

Aim
This study aims to gain an in-depth understanding of physicians’ personal preferences on end-of-life decisions, how preferences impact their clinical practice and how micro and macro level factors influence preferences. It will also involve comparison across six diverse countries.  

Methods
A mixed methods approach is being used: a quantitative survey in six countries: Belgium, Italy, the UK, Canada, the US (Georgia, Oregon & Wisconsin) and Australia (Queensland & Victoria); combined with a qualitative exploration using semi-structured interviews in Belgium, Italy and the US (Wisconsin).