November 2025, Volume 3, Issue 11

Author

Regina Roy, Aniket Kumar, Vijayamathy A and Fazulu Rahiman

Abstract

Background: Palliative care focuses on relieving symptoms and stress from serious illnesses, aiming to improve the quality of life for both patients and their families. It is appropriate at any stage of illness and can be provided alongside curative treatment. Advance Medical Directives (AMDs) are legal documents that allow individuals to outline their medical treatment preferences if they become unable to communicate. This study was intended to evaluate the perception of the Medical Community in this institution about Advance Medical Directives and End of Life Care, generating novel insights. Objectives: The primary objective was to evaluate the attitude and knowledge of the medical community (including faculty, interns, and undergraduates) regarding palliative care and Advance Medical Directives (AMDs). The secondary objective was to explore perceptions about implementing palliative care into the Competency-Based Medical Education (CBME) curriculum. Methods: A cross-sectional study was carried out for a period of one week in a tertiary care Centre after securing approval from the Institutional Human Ethics Committee. A total of 204 participants including faculty members, Interns, and undergraduates (from Phase 2 MBBS onwards were enrolled. Data were collected using a pre-designed, pre-validated questionnaire administered as Google Form for analysed using Statistical Package for Social Sciences (SPSS) software. Association between categorical variables was assessed by Chi-square test. The knowledge and attitude scores were correlated by Pearson correlation test. Results: Of the participants, 78% were females. Fear of death was identified as their greatest concern in terminal illness by 47.09% of participants. 77.67% of the participants believed that once an AMD is signed it remains valid for life. 28.16% of the participants were of the impression that AMDs are a legal form of euthanasia. Integration of palliative care into Phase 1 of the CBME curriculum was supported by 37%. There was no statistical significance in the correlation of knowledge with attitude which was weak negative (r = -0.108; p = 0.124). Conclusion: The medical community had a positive attitude towards AMDs despite having poor understanding. This emphasizes the necessity of creating more mindfulness and integration of AMD in curriculum.