Abstract
BackgroundThere has been no in-depth research of public attitudes on withholding or withdrawing life-prolonging treatment, euthanasia, assisted suicide and physician assisted suicide in Croatia. The aim of this study was to examine these attitudes and their correlation with sociodemographic characteristics, religion, political orientation, tolerance of personal choice, trust in physicians, health status, experiences with death and caring for the seriously ill, and attitudes towards death and dying.MethodsA cross-sectional study was conducted on a three-stage random sample of adult citizens of the Republic of Croatia, stratified by regions, counties, and locations within those counties (N = 1203). In addition to descriptive statistics, ANOVA and Chi-square tests were used to determine differences, and factor analysis (component model, varimax rotation and GK dimensionality reduction criterion), correlation analysis (Bivariate correlation, Pearson’s coefficient) and multiple regression analysis for data analysis.Results38.1% of the respondents agree with granting the wishes of dying people experiencing extreme and unbearable suffering, and withholding life-prolonging treatment, and 37.8% agree with respecting the wishes of such people, and withdrawing life-prolonging treatment. 77% of respondents think that withholding and withdrawing procedures should be regulated by law because of the fear of abuse. Opinions about the practice and regulation of euthanasia are divided. Those who are younger and middle-aged, with higher levels of education, living in big cities, and who have a more liberal worldview are more open to euthanasia. Assisted suicide is not considered to be an acceptable practice, with only 18.6% of respondents agreeing with it. However, 40.1% think that physician assisted suicide should be legalised. 51.6% would support the dying person’s autonomous decisions regarding end-of-life procedures.ConclusionsThe study found low levels of acceptance of withholding or withdrawing life-prolonging treatment, euthanasia, assisted suicide and physician assisted suicide in Croatia. In addition, it found evidence that age, level of education, political orientation, and place of residence have an impact on people’s views on euthanasia. There is a need for further research into attitudes on different end-of-life practices in Croatia.
Highlights
There has been no in-depth research of public attitudes on withholding or withdrawing life-prolonging treatment, euthanasia, assisted suicide and physician assisted suicide in Croatia
There is a need for further research into attitudes on different end-of-life practices in Croatia
The six groups of end-of-life practices usually distinguished in the literature are: intensified alleviation of symptoms with potentially life-shortening effects, withholding/withdrawing life-prolonging treatment, continuous deep sedation until death, euthanasia defined as administration of a lethal injection by a physician at the explicit request of the patient, physician-assisted suicide (suicide by a patient facilitated by means or by information, provided by a physician aware of the patient’s intent), and ending of life without explicit patient consent [1,2,3,4]
Summary
There has been no in-depth research of public attitudes on withholding or withdrawing life-prolonging treatment, euthanasia, assisted suicide and physician assisted suicide in Croatia. The six groups of end-of-life practices usually distinguished in the literature are: intensified alleviation of symptoms with potentially life-shortening effects, withholding/withdrawing life-prolonging treatment, continuous deep sedation until death, euthanasia defined as administration of a lethal injection by a physician at the explicit request of the patient, physician-assisted suicide (suicide by a patient facilitated by means (such as a drug prescription) or by information (such as an indication of a lethal dosage), provided by a physician aware of the patient’s intent), and ending of life without explicit patient consent [1,2,3,4] Some of these practices are more controversial than others. Acceptance levels of euthanasia and physician assisted suicide peaked in most countries, and in some countries a moderate decline was reported [6, 7, 11, 12]
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