Professionalism and Medical Ethics in End-of-Life Decision-Making: A Phenomenological Study of ICU Physicians at Public Teaching Hospital, Sahiwal, Pakistan

Objective: The study aimed to explore the lived experiences of ICU physicians in Pakistan regardingprofessionalism and medical ethics in end-of-life decision-making, with particular focus on emotional burden,ethical dilemmas, religious and cultural influences, family involvement, and institutional challenges.Study Design: A qualitative phenomenological study using a hermeneutic approach.Place and Duration of Study: The study was conducted in the Medical Intensive Care Unit at Sahiwal TeachingHospital, Sahiwal, Pakistan, from November 2024 to April 2025.Methods: Semi-structured, in-depth interviews were conducted over a period of six months in the MedicalIntensive Care Unit at Sahiwal Teaching Hospital with eight physicians and postgraduate trainees. They wereselected using a purposive sampling technique, and were directly involved in decision-making regarding endof-life care. Data was analyzed through thematic analysis. Credibility and dependability were ensured throughparticipant validation and expert peer review.Results: Six key themes emerged from the analysis using thematic analysis based on Braun and Clarke'sframework and supported by NVivo 12 Pro software: Emotional burden of decision-making, Religious andcultural influences, Family-centered pressure and misunderstanding, Systemic and institutional gaps, Personalbeliefs, professional ethics, and reflection, and External interference and hierarchical pressure. Physiciansdescribed moral distress, emotional exhaustion, and fear of legal repercussions in the absence of clearinstitutional protocols or legal protection. Family expectations and cultural norms frequently conflicted withmedical judgment, intensifying ethical challenges.Conclusion: End-of-life decision-making among Pakistani intensive care physicians is influenced by emotional,cultural, ethical, and institutional pressures. The findings suggest a need for improved institutional guidance,ethics training, and structured communication with families to support ethical practice, reduce physiciandistress, and promote more consistent end-of-life care. How to cite this: Waseem M, Ajmal MO, Butt WA, Mir A, UZ Mir, Qaiser A. Professionalism and Medical Ethics in End-of-Life Decision-Making: A Phenomenological Study of ICU Physicians at Public Teaching Hospital, Sahiwal, Pakistan. Life and Science. 2026; 7(1): 17-24. doi: http://doi.org/10.37185/LnS.1.1.1042