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To explore the relationships between personality characteristics, underlying attitudes, and treatment decisions for severely ill elderly patients in a sample of Russian doctors. ⋯ Physicians should be trained to improve their cooperative abilities in the treatment of severely ill elderly patients to be better prepared for their decision-making and coping concerning end-of-life decisions and the use of do-not-resuscitate orders and advance directives. Ethical values in clinical practice, especially patient autonomy, should be addressed during the early stage of the medical curriculum.