Attitudes of intensive care physicians towards terminal care management in Türkiye

Objective: This study aimed to evaluate the attitudes and perspectives of intensive care physicians in Turkey regarding terminal care management. The roles of sociodemographic factors, professional expertise, institutional settings, clinical preferences, medical ethics/intensive care training, and personal values in life-sustaining treatment decisions were examined. Materials and Methods: This cross-sectional, descriptive, and analytical field study targeted intensive care physicians across Turkey. Data were collected via an online survey comprising 38 questions structured into four sections: informed consent, sociodemographic data, professional experience, and scales assessing attitudes and knowledge levels toward terminal care management. Results: A total of 208 physicians participated, predominantly aged 30–39 and married; 91.3% (n=190) did not hold a subspecialty degree. Knowledge accuracy rates were 96.2% for euthanasia, 71.6%–74.0% for withholding/withdrawing treatment, and 52.9% for medical futility. While 80.3% would attempt to persuade a treatment-refusing patient, 57.7% would continue intervention despite the patient's will. Participants reported extreme anxiety regarding their own potential end-of-life processes, specifically intensive care admission (90.9%), device dependency (94.2%), and pain (93.3%). Multivariate regression analysis identified religiosity, specialized training, and marital status as independent predictors increasing the importance attributed to the "value of life." Conclusion: Findings underscore the need to clarify legal frameworks, ensure terminological consistency, and develop comprehensive clinical guidelines to improve terminal care management in Turkey. Enhancing psychosocial support and addressing chronic capacity shortages are essential for establishing a holistic and sustainable system.