Perceptions of Healthcare Personnel on End-of-Life Care: Challenges and Gaps in a High-Complexity Center

Introduction End-of-life patient care represents a clinical, ethical, and emotional challenge for healthcare professionals. Decision-making in this context demands specific competencies, interdisciplinary support, and institutional backing, particularly in high-complexity settings. Objective To evaluate healthcare personnel's perceptions regarding the management of end-of-life patients and describe their attitudes toward clinical, emotional, and ethical-legal decisions in this context. Methods A descriptive, cross-sectional study was conducted at Fundación Clínica Shaio (Bogotá, Colombia). A structured questionnaire, validated by subject-matter experts, was developed to assess four domains: medical interventions, emotional aspects, spiritual dimension, and academic training. The survey was distributed electronically via the REDCap platform and completed by 319 healthcare professionals. Statistical analysis was performed using SPSS v25.0. Results 78% of respondents frequently care for end-of-life patients; however, only 33% felt competent in their management. Palliative extubation (76.8%) and withdrawal of vasopressor support (70%) were the most accepted practices, while transfusion of blood components (56.7%) and renal replacement therapy (54.8%) generated more disagreement. A total of 93.3% considered interdisciplinary support, including psychological, spiritual, and social work services, as essential in this process. 82% deemed the signature of a do-not-resuscitate (DNR) consent necessary, and 74% expressed concern about potential medicolegal liability in the absence of such documentation. Additionally, 61% were unaware of the existence of institutional policies or protocols for managing patients at the end of life. Conclusion Healthcare personnel are highly exposed to end-of-life care, yet report mixed perceptions regarding their preparedness and appropriate interventions during this stage. Educational, institutional, and regulatory gaps were identified, underscoring the need to promote continuous education programs on end-of-life care, strengthen the ethical and humanistic approach, and implement institutional protocols to guide clinical decisions and ensure dignified, patient-centered care.