Received: Feb 17, 2024

Reviewers comments received: Mar 19, 2024

Revised paper received: May 29, 2024

Accepted: June 30, 2024

First published online as Epubahead: July 5, 2024

Ref – Shruthi, J Damodharan J. Knowledge and Attitude Towards End-of-Life care and Advance Directives amongst Medical Students and Postgraduates in a Tertiary care Hospital of South India. Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology [serial online], 2025; Vol. 26, No. 1 (Jan - June 2025): [about 19 p].

Available from: https://anilaggrawal.com/ij/vol-026-no-001/papers/paper001.

Published : Oct 18, 2023

DOI : 10.5281/zenodo.12666258

Email: shrupvs@gmail.com

( All photos can be enlarged on this webpage by clicking on them )

Knowledge and Attitude Towards End-of-Life care and Advance Directives amongst Medical Students and Postgraduates in a Tertiary care Hospital of South India

Abstract

Aim

This study was conducted to assess the knowledge and attitude towards end-of-life care and advance directives amongst medical students and postgraduates of Saveetha Medical College and Hospital which is located in the city of Chennai, India.

Methodology

A cross-sectional questionnaire based observational study was conducted taking 369 medical students including interns and 83 postgraduates of Saveetha Medical College and Hospital as participants. A structured, pre-tested and validated questionnaire was prepared containing 18 questions related to end of life care and advance directives which was provided to the participants via google forms after obtaining informed consent. In addition, sociodemographic parameters such as sex, religion, phase of study and health insurance were obtained.

Results

Out of the 1077 individuals surveyed, majority of the respondents were females (61.1%). Most of the respondents were Hindus (67.1%), followed by Christians (19.1%) and Muslims (13.8%). Only 39.5% of the population had health insurance coverage. 96.2% of the participants in the study were unaware of Advance Directives (AD) or its legalization in India. None of them had created an AD, with the lack of promotion in medical education being cited as the primary reason by 94% of respondents. 31.4% of the population found the existence of AD reasonable, 75.8% of them were uncertain about whether it should be mandatory for all citizens of India. 80.2% were oblivious that adhering to Do Not Resuscitate (DNR) orders without an AD is illegal in India, while 61.1% were uncertain whether passive euthanasia and DNR are components of an AD in India. More than 90% of the population lacked awareness regarding the legal age for drafting an AD or the involvement of a Surrogate in its preparation. Nobody was familiar with the process of preparing an AD or the modifications to SC.

Conclusion

This study highlights insufficient awareness concerning Advance Directives (AD). However, attitudes toward AD preparation and End-of-Life care discussions appear to be mixed.

Keywords

Advance Directive, Attitudes, End-Of-Life Care, Epistemology, Hospice Program, Living Will, Medical Students