Healthcare professionals’ experiences of participating in withdrawing life-sustaining treatment decisions in a Chinese intensive care unit: a qualitative study

Abstract Background The aging population and advancements in medical technology have intensified the emotional complexities faced by physicians and nurses in making decisions regarding life-sustaining treatment (LST). Aim This study explores healthcare professionals’ emotional and cognitive experiences in decisions to withdraw LST for ICU patients, identifies the factors influencing such decisions, and provides evidence-based recommendations to enhance their effective involvement in end-of-life decision-making. By addressing key challenges in this process, the findings aim to offer actionable insights and practical guidance for medical practitioners, policymakers, and healthcare institutions, particularly within the Chinese cultural context, to improve patient-centered care in end-of-life scenarios. A phenomenological qualitative approach was employed, utilizing convenience sampling of ten nurses and ten physicians from a tertiary ICU in China. Participants engaged in face-to-face, semi-structured interviews, which were transcribed verbatim and analyzed using Colaizzi’s method to identify and code themes. Findings Healthcare professionals’ experiences in withdrawing LST for ICU patients were classified into three primary themes and eight subthemes: perceptions of LST (professional and humanitarian perspectives); factors influencing decision-making (personal factors of healthcare professionals, family and societal culture, lack of preparedness, and ethical dilemmas); and differing viewpoints of nurses and physicians regarding the execution of LST. Conclusion The decision to withdraw LST presents multifaceted challenges, including conflicts arising from personal and professional differences among healthcare providers and the emotional complexities intrinsic to the process. Nurses, often constrained by clinical hierarchies and professional limitations, frequently have minimal influence in decision-making teams. Furthermore, communication between healthcare professionals and patients remains insufficient. To enhance the efficacy of decision-making in end-of-life care, improving interdisciplinary collaboration and fostering patient-centered trust are critical.