P-74 Threats to dignified end-of-life care in lithuania: the attitudes of healthcare professionals and citizens

Abstract

<h3>Background</h3> Protection of human dignity, especially in case of terminal (incurable) illness, is among the main pre-requisites of a just society. Although everyone agrees that dignity is the core of human rights, there are many (mis-)conceptions of its meaning. It is important that healthcare providers recognize patient’s needs that preserve his/her dignity most. The aim of this paper is to compare opinions of Lithuanian citizens and healthcare professionals on what may pose threat to human dignity in case of terminal illness at the end of life. <h3>Methods</h3> In 2021, a national representative survey of citizens (N=1110) and a survey of healthcare professionals who cared for terminally ill patients (snowball sampling; N=166) were organized in Lithuania. <h3>Results</h3> The findings revealed that higher proportions of healthcare professionals believed that ‘Dependence on others’ help’ (78.9% vs 56.3%), ‘Physiological problems’ (68.7% vs 55.3%), and ‘Reduction in or loss of privacy’ (62.0% vs 26.1%) are the dominating threats to dignity of terminally ill patients. Meanwhile, more citizens believed that ‘Difficulties in management of pain and unpleasant symptoms’ (53.4% vs 27.1%), ‘Knowledge that the illness is incurable’ (43.3% vs 20.5%), ‘Low quality of healthcare services’ (28.4% vs 17.5%), ‘Low accessibility to medicines and medicinal products’ (24.4% vs 2.4%), and ‘Difficulties in getting social support’ (23.7% vs 13.9%) reduce human dignity. <h3>Conclusion</h3> While health professionals saw physiological and autonomy related issues as negatively affecting patients’ dignity, the citizens believed that, besides the knowledge that the illness is incurable, accessibility and quality of health and social care services need to be tackled with empathetic commitment and patient-centered approach. Health and social care systems should focus not only on the quality of health and social care services but also care about the mode of delivery of services to terminally ill patients so they felt dignified until the last moments of life.