Perception of Medical Students on the Need for End-of-Life Care. A Q-Methodology Study

Background: End-of-life care and the limitation of therapeutic effort are among the most controversial aspects of medical practice. There are many factors that can influence decision-making regarding these issues. Most of them are subjective and personal. In this context, the Q methodology provides a scientific basis for the systematic study of subjectivity by identifying different thought patterns. Medical students will soon deal with difficult situations related to this topic. Being aware of their different views and the factors related to these will help to identify areas of improvement in the medical curricula. Methods Q methodology analysis was performed to find student´s profiles. 143 students of the School of Medicine of the Cantabria University (Spain) participated. A chi-square test was used to compare proportions. Results We obtained three opinion profiles: the first seeks to ensure quality of life and attaches great importance to the patient’s wishes; the second prioritizes life extension above anything else; the third incorporates the economic perspective into medical decision-making, prioritizing healthcare investment in patients with healing possibilities. Those who had religious beliefs were mostly included in profile 2 (48.8% vs 7.3% in profile 1 and 43.9% in profile 3), and those who considered that their beliefs did not influence their ethical principles, were mainly included in profile 3 (48.5% vs 24.7% in profile 1 and 26.8% in profile 2). Conclusions The different profiles on end-of-life care amongst medical students are influenced by personal factors (beliefs, experience with terminally ill patients).Increasing the clinical experience of students with terminally ill patients and reinforcing bioethics and health economics contents in medical schools’ curricula would contribute to developing knowledge-based opinion profiles and would avoid relying on personal experiences.