End of Life Discussion in an Academic Family Health Team in Kingston, Ontario, Canada

BACKGROUND: End-of-life (EOL) discussions remain difficult in non-terminal patients as death is often perceived as a taboo and uncertainty. However, the call for proper EOL discussions has recently received public attention and media coverage. Evidence also reveals that non-terminal patients are more satisfied with health-care encounters when EOL has been discussed. OBJECTIVES AND METHODS: The objective of this study was to explore the prevalence of EOL discussions in non-terminal adult patients, the perceived barriers to such discussions and suggested methods for improvement. A study mixed-methods study was performed by a group of PGY1 family medicine residents in an academic health team in Kingston, Ontario. RESULTS: EOL discussion was performed in a very small proportion of non-terminal patient encounters. Compared with attending physicians, residents were less likely to discuss EOL issues and reported more perceived barriers. CONCLUSION: Our findings reflect the need for an early and open approach in conducting EOL discussion for non-terminal healthy patients.