Perspectives of geriatricians on death and end-of-life care in a hospital in Bogotá-Colombia: a qualitative approach

End-of-life care planning (ELCP) is a sensitive and an underexplored area in Colombian healthcare, where legislation exists but guidance for hospital practice and education remains limited. This qualitative ethnographic study examined how geriatricians and residents in a university hospital represent and navigate ELCP. Data were collected through nine interviews, two focus groups, and three sets of field diaries, and analysed using a mixed thematic-content approach with triangulation and reflexive team discussion. Five interrelated themes emerged. Participants described insufficient training on death and dying, noting that most education focused narrowly on opioid use rather than broader ethical and emotional dimensions. Institutional variability was evident, with geriatrics and palliative care fostering practices rarely adopted in other services. Communication challenges were recurrent, as clinicians struggled to deliver bad news and negotiate therapeutic reorientation with families. Decision-making around palliative sedation highlighted ethical tensions and reliance on hospital ethics committees for legitimacy. Emotional impact and moral distress were consistently reported, with narratives showing how experience transforms raw distress into more reflective approaches to dying. Our findings reveal that geriatrics contributes to reframing death as a clinical reality requiring competence, empathy, and curricular reform; these insights may inform institutional policies and advance debates on end-of-life care in Latin America and globally.