Validation of an instrument to measure respect for the autonomy of terminally ill patients during end-of-life medical decision-making

Abstract

Background: Respect for the autonomy of the person consists in considering the preferences and values of the sick person when making decisions about the type of care they receive and is a bioethical-legal element. However, there are no validated instruments on this phenomenon that help to clarify the physician's perception of this principle.

Objective: To elaborate, validate through expert judgment and determine the internal consistency of an instrument that evaluates the level of agreement that the doctors have on the different elements that constitute respect for the autonomy of the terminally ill person.

Methods: Cross-sectional study. The expert judgment validation method was used with a panel of ten experts from Mexico. The instrument was piloted in doctors of a highly specialized public hospital to determinate its internal consistency.

Results: An instrument of 15 items was generated with a content validity index of 0.82 for 10 experts. It was piloted in a sample of 96 doctors (31.3% female and 68.7% male) and with an average age of 30 years. The Cronbach's alpha was 0.694.

Conclusions: A questionnaire was developed to measure the level of agreement that the doctor who cares for terminally ill people has in relation to the constitutive aspects of respect for their autonomy. Based on the results of the validation and internal consistency, its application in medical populations is recommended to corroborate its usefulness and favor a simple situational diagnosis of the situation studied.