Physician estimates of the feasibility of preserving the dying for future revival

ImportanceTerminally ill patients sometimes inquire about preservation procedures (e.g. cryopreservation, aldehyde-based fixation) as end-of-life treatment options, yet physician perspectives on feasibility and ethical acceptability remain uncharacterized. ObjectiveTo assess US physicians estimates of preservation feasibility, views on interventions to improve outcomes, and positions on ethical and legal frameworks. DesignCross-sectional survey conducted October 2025. SettingSermo, an online platform for verified US healthcare professionals. ParticipantsConvenience sample of 334 physicians comprising 150 primary care physicians (general practice, internal medicine, family medicine) and 184 other specialists. Main Outcomes and MeasuresEstimated probability that preservation retains neurally-encoded information sufficient for future revival; support for pre-mortem anticoagulation and pre-cardiac arrest procedure initiation; views on compatibility with patient-centered care. ResultsAmong 334 physicians, the median estimated probability that preservation under ideal conditions could retain sufficient neural information for future revival was 25.5%. Overall, 27.9% found preservation somewhat or very plausible for enabling future revival; 47.0% found it somewhat or very implausible. Most physicians (70.7%) supported prescribing anticoagulants to terminal patients to improve preservation quality; 11.7% opposed. For patients choosing preservation in combination with medical assistance in dying, 44.3% supported initiating preservation prior to cardiac arrest; 28.8% opposed. Most (58.1%) agreed preservation could be consistent with compassionate care (20.1% disagreed), and 49.1% reported comfort with patients choosing preservation (30.0% uncomfortable). Familiarity with preservation correlated with higher probability estimates ({rho} = 0.26; p < 10-3), while end-of-life discussion frequency correlated with support for pre-cardiac arrest procedures ({rho} = 0.18; p = 0.003). Conclusions and RelevanceUS physicians assigned a median 25.5% probability to preservation retaining neural information under ideal conditions in a manner potentially compatible with future patient revival. The majority support for pre-mortem anticoagulation and substantial support for pre-cardiac arrest initiation indicate that many physicians would consider accommodating patient requests for preservation-enhancing interventions. These findings may inform development of clinical guidelines, though the speculative nature of the estimates warrants consideration. Key PointsO_ST_ABSQuestionC_ST_ABSHow do US physicians estimate the feasibility of preserving terminally ill patients for potential future revival, and what interventions would they support to improve outcomes? FindingsIn this cross-sectional survey of 334 physicians, the median estimated probability that preservation could retain neural information sufficient for future revival was 25.5%; 70.7% supported prescribing anticoagulants to improve preservation quality, and 44.3% supported initiating preservation prior to cardiac arrest for patients choosing medical assistance in dying. MeaningNon-trivial physician support for preservations feasibility and acceptability suggests a need to develop guidelines addressing preservation as an end-of-life option.