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A comparison of attitudes towards end-of-life decisions: Survey among the Dutch general public and physicians

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  • Rietjens, Judith A.C.
  • van der Heide, Agnes
  • Onwuteaka-Philipsen, Bregje D.
  • van der Maas, Paul J.
  • van der Wal, Gerrit

Abstract

In The Netherlands, there has been a continuing public debate about the acceptability and regulatory system for medical decision-making concerning the end of life. We studied attitudes of the Dutch general public towards different types of end-of-life decisions in various situations and compared them to attitudes of physicians. Questionnaires were mailed to 1777 members of the Dutch general public (response: 78%). A total of 391 Dutch physicians, including general practitioners, nursing home physicians and clinical specialists, were interviewed in person (response: 81%). In both the survey and physician interviews, questions were asked about attitudes towards active ending of life, terminal sedation, and increasing morphine with premature death as a likely consequence, using hypothetical cases of different patients. By logistic regression analysis, the differences between public and physicians' attitudes were assessed, as well as the associations between attitudes of the general public and their personal characteristics. Acceptance of active ending of life at the request of a terminally ill cancer patient was higher among the general public (85%) than among physicians (64%). For physicians, acceptance decreased to 36% for an incompetent adult, 11% for a patient without a serious disease, and 6% for a patient with dementia. For the general public, these percentages were 63%, 37%, and 62%, respectively. Between both groups, no differences were found in acceptance of terminal sedation and increasing morphine. For the general public, determinants of support for active ending of life were being non-religious, lower education, and having a single household. Acknowledging the observed differences in appreciation of end-of-life decision-making between the general public and physicians is important in doctor-patient communication and in public debate and policymaking. Continued monitoring of practices and informing the general public and policymakers about the clinical and ethical consequences of different types of end-of-life decisions is important.

Suggested Citation

  • Rietjens, Judith A.C. & van der Heide, Agnes & Onwuteaka-Philipsen, Bregje D. & van der Maas, Paul J. & van der Wal, Gerrit, 2005. "A comparison of attitudes towards end-of-life decisions: Survey among the Dutch general public and physicians," Social Science & Medicine, Elsevier, vol. 61(8), pages 1723-1732, October.
    • Handle: RePEc:eee:socmed:v:61:y:2005:i:8:p:1723-1732
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    References listed on IDEAS

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    1. Singer, Peter A. & Choudhry, Sujit & Armstrong, Jane & Meslin, Eric M. & Lowy, Frederick H., 1995. "Public opinion regarding end-of-life decisions: Influence of prognosis, practice and process," Social Science & Medicine, Elsevier, vol. 41(11), pages 1517-1521, December.
    2. F. Mortier & J. Bilsen & R. H. Vander Stichele & J. Bernheim & L. Deliens, 2003. "Attitudes, Sociodemographic Characteristics, and Actual End-of-Life Decisions of Physicians in Flanders, Belgium," Medical Decision Making, , vol. 23(6), pages 502-510, November.
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    1. Sarah Vilpert & Carmen Borrat-Besson & Gian Domenico Borasio & Jürgen Maurer, 2020. "Associations of end-of-life preferences and trust in institutions with public support for assisted suicide evidence from nationally representative survey data of older adults in Switzerland," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-18, April.
    2. Young Ho Yun & Jin-Ah Sim & Yeani Choi & Hyejeong Yoon, 2022. "Attitudes toward the Legalization of Euthanasia or Physician-Assisted Suicide in South Korea: A Cross-Sectional Survey," IJERPH, MDPI, vol. 19(9), pages 1-10, April.
    3. Erwin Stolz & Nathalie Burkert & Franziska Großschädl & Éva Rásky & Willibald J Stronegger & Wolfgang Freidl, 2015. "Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-15, April.
    4. Joachim Cohen & Paul Landeghem & Nico Carpentier & Luc Deliens, 2014. "Public acceptance of euthanasia in Europe: a survey study in 47 countries," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(1), pages 143-156, February.

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