Area of Science:

• Palliative Care
• Medical Ethics
• Health Services Research

Background:

• Growing attention to end-of-life care in France and Europe over 15 years.
• Limited reliable data collection and scientific studies on end-of-life situations.
• Lack of a recognized and operational definition of 'end of life' hinders research.

Purpose of the Study:

• To explore the possibility of achieving consensus on a definition of end of life.
• To identify and evaluate proposed definitions based on existing literature.

Main Methods:

• Utilized a Delphi consensus approach to avoid leadership bias.
• Surveyed 1463 care providers from the French Society for Support and Palliative Care (SFAP).
• Employed an electronic survey with a Likert scale to gauge agreement on proposed definitions.

Main Results:

• Two dominant definition types emerged: time-based (life expectancy <15 days or <1 month) and disease-based (advanced/terminal phase of incurable pathology).
• Results indicate a temporal perspective (time left to live) and a disease-centered perspective (terminal phase) are primary viewpoints.
• An alternative definition was identified for further testing in the second Delphi round.

Conclusions:

• Consensus on an end-of-life definition is achievable through structured approaches like the Delphi method.
• The study highlights two main conceptualizations of end of life: temporal and disease-progression focused.
• Further research is needed to refine and validate a universally accepted operational definition for end-of-life care.