Comparison of attitudes towards five end-of-life care interventions (active pain control, withdrawal of futile life-sustaining treatment, passive euthanasia, active euthanasia and physician-assisted suicide): a multicentred cross-sectional survey of Korean patients with cancer, their family caregivers, physicians and the general Korean population. Issue 9 (11th September 2018)

• Record Type: Journal Article
• Authors: Yun, Young Ho; Kim, Kyoung-Nam; Sim, Jin-Ah; Yoo, Shin Hye; Kim, Miso; Kim, Young Ae; Kang, Beo Deul; Shim, Hyun-Jeong; Song, Eun-Kee; Kang, Jung Hun; Kwon, Jung Hye; Lee, Jung Lim; Nam, Eun Mi; Maeng, Chi Hoon; Kang, Eun Joo; Do, Young Rok; Choi, Yoon Seok; Jung, Kyung Hae
• Is Part Of: BMJ open. Volume 8:Issue 9(2018)
• Publication Date: 2018-09-11
• Subjects: attitudes toward death -- modes of death -- active pain control -- passive euthanasia -- active euthanasia -- PAS; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2017-020519
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: This study determined attitudes of four groups—Korean patients with cancer, their family caregivers, physicians and the general Korean population—towards five critical end-of-life (EOL) interventions—active pain control, withdrawal of futile life-sustaining treatment (LST), passive euthanasia, active euthanasia and physician-assisted suicide. Design and setting: We enrolled 1001 patients with cancer and 1006 caregivers from 12 large hospitals in Korea, 1241 members of the general population and 928 physicians from each of the 12 hospitals and the Korean Medical Association. We analysed the associations of demographic factors, attitudes towards death and the important components of a 'good death' with critical interventions at EoL care. Results: All participant groups strongly favoured active pain control and withdrawal of futile LST but differed in attitudes towards the other four EoL interventions. Physicians (98.9%) favoured passive euthanasia more than the other three groups. Lower proportions of the four groups favoured active euthanasia or PAS. Multiple logistic regression showed that education (adjusted OR (aOR) 1.77, 95% CI 1.33 to 2.36), caregiver role (aOR 1.67, 95% CI 1.34 to 2.08) and considering death as the ending of life (aOR 1.66, 95% CI 1.05 to 1.61) were associated with preference for active pain control. Attitudes towards death, including belief in being remembered (aOR 2.03, 95% CI 1.48 to 2.79) and feeling 'life was meaningful' (aOR 2.56, 95% CI 1.58 to 4.15) were both strong correlates of withdrawal of LST with the level of monthly income (aOR 2.56, 95% CI 1.58 to 4.15). Believing 'freedom from pain' negatively predicted preference for passive euthanasia (aOR 0.69, 95% CI 0.55 to 0.85). In addition, 'not being a burden to the family' was positively related to preferences for active euthanasia (aOR 1.62, 95% CI 1.39 to 1.90) and PAS (aOR 1.61, 95% CI 1.37 to 1.89). Conclusion: Groups differed in their attitudes towards the five EoL interventions, and those attitudes were significantly associated with various attitudes towards death.