Abstract
BackgroundEnd-of-life decisions remain a hotly debated issue in many European countries and the acceptance in the general population can act as an important anchor point in these discussions. Previous studies on determinants of the acceptance of end-of-life interventions in the general population have not systematically assessed whether determinants differ between withdrawal of life-prolonging treatment (WLPT) and euthanasia (EUT).MethodsA large, representative survey of the Austrian adult population conducted in 2014 (n = 1,971) included items on WLPT and EUT. We constructed the following categorical outcome: (1) rejection of both WLPT and EUT, (2) approval of WLPT but rejection of EUT, and (3) approval of both WLPT and EUT. The influence of socio-demographics, personal experiences, and religious and socio-cultural orientations on the three levels of approval were assessed via multinomial logistic regression analysis.ResultsHigher education and stronger socio-cultural liberal orientations increased the likelihood of approving both WLPT and EUT; personal experience with end-of-life care increased only the likelihood of approval of WLPT; and religiosity decreased approval of EUT only.ConclusionThis study found evidence for both shared (education, liberalism) and different (religiosity, care experiences) determinants for the acceptance of WLPT and EUT.
Highlights
End-of-life decisions remain a hotly debated issue in many European countries and the acceptance in the general population can act as an important anchor point in these discussions
People without religious confession appeared notably more inclined to approve of both end-oflife interventions than to those belonging to religious denominations
A clear bivariate difference was found between those rejecting both end-of-life interventions, and those approving of EUT and withdrawal of life-prolonging treatment (WLPT)
Summary
End-of-life decisions remain a hotly debated issue in many European countries and the acceptance in the general population can act as an important anchor point in these discussions. End-of-life decisions and euthanasia are still controversially disputed in public and medical discourse in Europe, against the background of liberal legalisation in some Western European countries [1], increasing public acceptance [2], higher life expectancy and hereafter chronic suffering. Most discussions in this context, for which the acceptance in the general population can act as an anchor, tend to centre on euthanasia (EUT), i.e. on the voluntary hastening of death by having medical personnel deliberately administrate drugs with the intention to cause the patient’s death, whereas the. The limiting factors of these studies are that they relied on a few (dichotomised) predictors or applied bivariate statistical tests only, and that they compared acceptance for WLPT and EUT separately, instead of explicitly linking these two forms of end-of-life decisions
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