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Table 1 Questions used in the survey (for the complete questionnaire, please see Additional File)

From: Knowledge and attitudes about end-of-life decisions, good death and principles of medical ethics among doctors in tertiary care hospitals in Sri Lanka: a cross-sectional study

On breaking bad news
1. According to your knowledge, in a patient with advanced, progressive, incurable disease, with whom should the doctor discuss the diagnosis and prognosis? (Select one response only)
 a. The patient only
 b. The patient’s immediate family only
 c. Both the patient and family
 d. None
 e. Other (please specify)
2. What are your attitudes on informing the patient about a diagnosis of terminal illness and its prognosis? (indicate your opinion of each statement as Strongly agree; Agree; Disagree; or Strongly disagree)
 a. It will make the patient depressed
 b. Is of no benefit to the patient
 c. A grief reaction will occur, but the patient will adjust
 d. It will reduce the patient’s anxiety associated with uncertainty
 e. To know when death is coming is an essential prerequisite for a good death
 f. The family (not the doctor) should break the news to the patient
On advance directives
3. Are you aware of advance directives (living wills)? (Select one response only)
 a. No, I have never heard of it
 b. I have heard, but not well aware of it
 c. I am well aware of it
4. Can an attempted suicide (deliberate self-harm) be considered as an advance refusal of life-saving treatment? YES/NO
5. Would you transfuse blood in a patient in vascular shock due to active gastric bleeding and a haemoglobin of 4 g/dl, even if the patient has made an advance refusal of receiving any blood products? YES/NO
On withdrawal and withholding life sustaining treatment
6. A 28-year-old doctor with metastatic carcinoma has developed respiratory failure. She could live for several weeks if she is placed on a ventilator. Would you place her on a ventilator? YES/NO
7. A 28-year-old doctor who was ventilated following a road traffic accident has been confirmed to be brain dead. A 28-year-old man is in urgent need for a ventilator following deliberate self-harm with an insecticide. He could be saved if placed on a ventilator. There are no vacant ventilators available. Would you disconnect the doctor from the ventilator? YES/NO
8. What time would you record as the ‘time of death’ in a brain-dead patient who is disconnected from the ventilator?
9. Do you feel more comfortable to withhold than to withdraw life-sustaining therapy? YES/NO
On ‘Do-not-attempt cardiopulmonary resuscitation (DNACPR)’ decisions
10. Are you aware of ‘do-not-attempt cardiopulmonary resuscitation (DNACPR)’ decisions? (Select one response only)
 a. No, I have never heard of it
 b. I have heard, but not well aware of it
 c. I am well aware of it
If the answer is ‘a’ please skip question 11–15
11. When would you consider a DNACPR order appropriate?
12. Who should make the DNACPR decision in an unconscious patient? (select one response only)
 a. The medical team only
 b. The family only
 c. Both the medical team and family
 d. Other (please specify):
13. Is it appropriate to withdraw all life sustaining therapy once a DNACPR decision has been made? YES/NO/DO NOT KNOW
14. Would you feel reluctant to make a DNACPR decision on a patient? YES/NO If yes, why?
15. Have you been involved in DNACPR decision? YES/NO
On the concept of a ‘Good Death’
16. Once ‘dying’ (end-of-life) has been diagnosed, who should take the lead role in ensuring that the patient has a good death? (Select one response only)
 a. The caring physician
 b. The family
 c. A spiritual leader
 d. Nursing staff
 e. Other (please specify)
17. What would you consider as essential characteristics of a good death? (mark correct responses only)
 1. To know when death is coming and to understand what can be expected
 2. To be able to retain control of what happens
 3. To be afforded dignity and privacy
 4. To have control over pain and other symptom control
 5. To have choice and control over where death occurs (at home or elsewhere)
 6. To have access to information and expertise of whatever kind is necessary
 7. To have access to any spiritual or emotional support required
 8. To have access to hospice care in any location, not only in hospital
 9. To have control over who is present and who shares the end
 10. To have time to say goodbye, and control over other aspects of timing
 11. To be able to leave when it is time to go, and not to have life prolonged pointlessly
 12. To have lived a long life
 13. To have lived a wholesome (virtuous) life
 14. To be able to issue advance directives which ensure wishes are respected
On medical ethics
18. Name the four principles of medical ethics
19. Should physician aid-in-dying (which includes both ‘physician-assisted suicide’ and ‘euthanasia’) be legalized in Sri Lanka for patients with incurable, progressive and painful disease? YES/NO