Knowledge and attitude towards advance directives for patients with terminal illnesses among doctors working in a tertiary care hospital

Background Advance directives help strike a balance between the ethical concepts of paternalism and patient autonomy in medical practice. It supports end-of-life decisions by the patient within an appropriate legal and ethical framework. This concept is still in its infancy in India and is an under-researched area. We aimed to assess the knowledge and attitudes of medical professionals on advance directives in a tertiary care teaching hospital. Methods Medical doctors from all departments were invited to participate in this survey using systematic sampling. The knowledge and attitude questionnaire was administered after obtaining informed consent. Socio-demographic and professional details were also collected. Descriptive, bivariate, and multivariate statistics were obtained using SPSS version 16.0.1. Results Our study included 391 medical doctors; 168 (43%) had good knowledge of advance directives, and 129 (33%) had a positive attitude towards them. Doctors who had completed postgraduate training in their specialty had better knowledge. Positive attitudes to advance directives were associated with greater knowledge and working in a super specialty department, while negative attitudes were associated with being more religious. Conclusion The level of knowledge and attitudes towards advance directives among medical practitioners is inadequate. While training will help improve knowledge and attitudes, other socio-cultural factors may also influence the same.