Earlier Survey Research Articles

Use of distributional weights in cost–benefit analysis revisited

ABSTRACT It is nearly 40 years since an earlier survey on the use of distributional weights in Cost-Benefitcost–benefit analysis was first published. Since then, a number of significant contributions have been made in the literature. It is therefore timely to revisit the issue by focusing on the key reasons why distributional weights are so necessary. We present a new justification for using unequal income distributional weights in CBA, and and reaffirm a completely neglected reason for adopting distribution weights. We derive the weights from a formulation of the SWF. We specify the minimum value judgmentsjudgements for the SWF that everyone can agree on who accepts the fundamentals of welfare economics. As many CBA practitioners have ignored using distribution weights, inadequate attention has been given to how they can be estimated. The final objective of this paper is to highlight the main methods for estimating these weights, and and to present applications of these methods.

Equalizing solar panel adoption across immigrant groups

This study seeks to understand the difference in solar-panel adoption across country-of-birth groups in Australia. Households with a respondent born in Australia, New Zealand, or North-West Europe are more likely to own their home and to have solar panels than households with respondents born elsewhere. The solar-uptake difference is substantial at around five percentage points, based on the 2019–20 Survey of Income and Housing. Renting status accounts for around 35% of the explained solar-uptake difference across country-of-birth groups using the 2019–20 survey and higher proportions using earlier surveys. Results are robust to inclusion of variables for key influences on solar adoption, such as wealth. Detailed location variables account for further differences in solar adoption that are not captured by other controls. The key implication is that policy to promote solar-panel adoption on rental housing could also make a major contribution toward improving equality of solar-panel adoption for country-of-birth groups. The decomposition approach in this paper could be useful for future studies which can suggest policies to reduce inequality in other contexts.

Paschen-line Constraints on Dust Attenuation and Star Formation at z ∼ 1–3 with JWST/NIRSpec

We use medium-resolution JWST/NIRSpec observations from the Cosmic Evolution Early Release Science Survey to place the first constraints on dust attenuation and star formation based on Paschen lines for a sizable sample of 63 galaxies at redshifts z = 1.0–3.1. Our analysis indicates strong correlations between the Balmer decrement, Hα/Hβ, and line ratios that include Paschen lines (i.e., Paα/Hβ, Paβ/Hβ, and the Paschen decrement, Paα/Paβ), suggesting that the former is sensitive to the overall dust obscuration toward H ii regions in high-redshift galaxies. The line ratios are used to derive nebular reddening, E(B − V)neb, and star formation rates (SFRs). There is marginal evidence that the SFRs deduced from Paschen lines may exceed by ≈25% those derived from Balmer lines alone, suggesting the presence of star formation that is optically thick in Balmer lines, though deeper observations are needed to confirm this result. Using the Paschen-line constraints on the bolometric SFRs, we reevaluate the relationship between dust obscuration and UV spectral slope, and find a reddening of the UV continuum that, on average, follows the SMC extinction curve. This analysis highlights the need for deeper spectroscopy of more representative samples to evaluate nebular dust attenuation and bolometric SFRs in high-redshift galaxies, and their relationship to the reddening of the UV continuum.

Core Challenges of Social Robot Navigation: A Survey

Robot navigation in crowded public spaces is a complex task that requires addressing a variety of engineering and human factors challenges. These challenges have motivated a great amount of research resulting in important developments for the fields of robotics and human-robot interaction over the past three decades. Despite the significant progress and the massive recent interest, we observe a number of significant remaining challenges that prohibit the seamless deployment of autonomous robots in crowded environments. In this survey article, we organize existing challenges into a set of categories related to broader open problems in robot planning, behavior design, and evaluation methodologies. Within these categories, we review past work and offer directions for future research. Our work builds upon and extends earlier survey efforts by (a) taking a critical perspective and diagnosing fundamental limitations of adopted practices in the field and (b) offering constructive feedback and ideas that could inspire research in the field over the coming decade.

The glacial geomorphology of the Mackenzie Mountains region, Canada

ABSTRACT During the Last Glacial Maximum, the Mackenzie Mountains region was glaciated by three distinct ice sources; the Laurentide Ice Sheet, the Cordilleran Ice Sheet, and independent montane glaciers. Rapid ice sheet thinning of the Laurentide-Cordilleran ice saddle in the south of this region contributed to rapid sea level rise events and influenced the style of deglaciation to the north. The current understanding of the glacial history of the broader region has been established through mapping from aerial imagery and early surveys between the early 1970s to the 2010s. The central portions of the Mackenzie Mountains have not yet been mapped. We present a new glacial geomorphological map for the Mackenzie Mountains region covering over 220,000 km2. This updated geomorphological map will form the basis of future work to reconstruct the former maximum ice extents, flow dynamics, and retreat pattern.

Early-onset Parkinson's disease: An assessment of unmet psychosocial needs

BackgroundEarly onset Parkinson's disease (EOPD) affects people in the prime of their lives, typically between 21 and 50 years of age, which results in a variety of challenges that are unique compared to those diagnosed later in life. A better understanding of the unmet needs of this population is critical to delivering bespoke care and improving their quality of life. ObjectivesTo assess the unmet needs of people with early onset Parkinson's disease. MethodsA cross-sectional sample of 198 adults with self-identified early onset Parkinson's disease completed surveys to ascertain the most common unmet needs of this population. Simple descriptive statistics including frequencies, means, and standard deviations were used to quantify the most common unmet needs and were compared between men, women, and Hispanic/Latino with significance determined by chi-square tests. ResultsOverall, the top five unmet needs were (1) need for “a community more like me” (65.2%), (2) more PD information (48%), (3) information about how their PD will progress (47%), (4) help with mental health issues (34.8%), and (5) help with employment issues (33.8%). The top unmet need for men was help with employment issues (50.8%), for women, “a community more like me” (72.3%), and for Hispanic/Latinos, more PD information (47%). ConclusionAlthough the number of people living with EOPD is considerably smaller than those with conventional age at onset, the potential impact to quality of life in this population remains tremendous. We propose a framework to start to address these needs.

Survey of ESCRS members' attitudes toward operating room waste.

In a survey of ESCRS member cataract surgeons, 92% felt that operating room waste is excessive and should be reduced; 99% were concerned about global warming and climate change. Most respondents cited restrictions on reuse by manufacturers and regulatory bodies as major drivers of this waste. There was a strong desire to have more reusable options for instruments, devices, and supplies. In comparable percentages with an earlier survey of North American cataract surgeons using the identical questionnaire, there was a strong willingness to reuse many surgical supplies, as well as topical and intraocular medications. This was true even though ESCRS members were much more likely to practice in hospitals (68% vs 35%). The similarities of these results to the North American survey suggest that these attitudes toward sustainability are in fact global and universal. The strong concordance between the 2 surveys suggests that global collaboration is both possible and necessary.

Monitoring for a new I3 resistance gene-breaking race of F. oxysporum f. sp. lycopersici (Fusarium wilt) in California processing tomatoes following recent widespread adoption of resistant (F3) cultivars: Challenges with race 3 and 4 differentiation methods.

Fusarium wilt, caused by Fusarium oxysporum f. sp. lycopersici (Fol), causes losses in tomato production worldwide, with major impacts on Californian tomato processing. Single-gene resistance is the primary management tool, but its efficacy has been compromised following the emergence of two successive resistance-breaking races, which, in California, emerged within 12years of resistance deployment. Fol race 3-resistant (F3) processing tomato cultivars (containing the I3 resistance gene) were deployed in the state starting in approximately 2009. The emergence of a new resistance-breaking race (which would be called race 4) is imminent, and early detection will be critical to delay the spread while new resistance is sought. The detection of Fol race 4 is challenged by the lack of validated, rapid, and accurate diagnostic tools. In evaluating in planta phenotyping methods, this study found that rapid seedling phenotyping is not reliable and generates false positives for nonpathogens. Longer (10weeks) mature plant assays are the most reliable, but may not be sufficiently timely. As an additional challenge, based on field and greenhouse studies, Fol race 3 can cause symptoms in resistant F3 cultivars at frequencies greater (30%) than expected for off-types (<2%). We developed a three-F3 cultivar in planta assay to overcome the challenges this posed to differentiating Fol race 3 and Fol race 4. Using the assay, we determined that all putative resistance-breaking cases were Fol race 3; Fol race 4 was not detected in these early survey efforts. These results highlight the need for developing rapid Fol race 4 detection tools and a better understanding of the factors underlying inconsistent I3 gene expression in Fol race 3.

Relative role of border restrictions, case finding and contact tracing in controlling SARS-CoV-2 in the presence of undetected transmission: a mathematical modelling study

BackgroundUnderstanding the overall effectiveness of non-pharmaceutical interventions to control the COVID-19 pandemic and reduce the burden of disease is crucial for future pandemic planning. However, quantifying the effectiveness of specific control measures and the extent of missed infections, in the absence of early large-scale serological surveys or random community testing, has remained challenging.MethodsCombining data on notified local COVID-19 cases with known and unknown sources of infections in Singapore with a branching process model, we reconstructed the incidence of missed infections during the early phase of the wild-type SARS-CoV-2 and Delta variant transmission. We then estimated the relative effectiveness of border control measures, case finding and contact tracing when there was no or low vaccine coverage in the population. We compared the risk of ICU admission and death between the wild-type SARS-CoV-2 and the Delta variant in notified cases and all infections.ResultsWe estimated strict border control measures were associated with 0.2 (95% credible intervals, CrI 0.04–0.8) missed imported infections per notified case between July and December 2020, a decline from around 1 missed imported infection per notified case in the early phases of the pandemic. Contact tracing was estimated to identify 78% (95% CrI 62–93%) of the secondary infections generated by notified cases before the partial lockdown in Apr 2020, but this declined to 63% (95% CrI 56–71%) during the lockdown and rebounded to 78% (95% CrI 58–94%) during reopening in Jul 2020. The contribution of contact tracing towards overall outbreak control also hinges on ability to find cases with unknown sources of infection: 42% (95% CrI 12–84%) of such cases were found prior to the lockdown; 10% (95% CrI 7–15%) during the lockdown; 47% (95% CrI 17–85%) during reopening, due to increased testing capacity and health-seeking behaviour. We estimated around 63% (95% CrI 49–78%) of the wild-type SARS-CoV-2 infections were undetected during 2020 and around 70% (95% CrI 49–91%) for the Delta variant in 2021.ConclusionsCombining models with case linkage data enables evaluation of the effectiveness of different components of outbreak control measures, and provides more reliable situational awareness when some cases are missed. Using such approaches for early identification of the weakest link in containment efforts could help policy makers to better redirect limited resources to strengthen outbreak control.

A Follow-Up Study on Delivery of Pharmacy Law Education Across Doctor of Pharmacy Programs

ObjectiveTo present 2018–2019 data from an expanded investigation after an inaugural 2016 pilot survey, which previously reported on the delivery of pharmacy law education in doctor of pharmacy (PharmD) programs in the US. MethodsDue to the limited scope of responses in the 2016 pilot study, the earlier survey was refined and readministered (Qualtrics, Provo, UT) utilizing branching logic to specifically identify characteristics of the pharmacy law content and its delivery in PharmD curricula. The follow-up study received an exempt status from the Institutional Review Board of Keck Graduate Institute. ResultsOf the 142 American Association of Colleges of Pharmacy member institutions in 2018, 97 provided complete responses to the survey, yielding a response rate of 68.3%. The survey results from this 2018–2019 further investigation examining the delivery of pharmacy law education in US PharmD programs indicate significant variations across respondent programs with respect to professional background of pharmacy law educators and assessment strategies used in pharmacy law courses, as well as variations in the structure and timing of the core pharmacy law course within the PharmD curriculum. ConclusionThe current data show PharmD curricula at surveyed institutions lack uniformity in pharmacy law content and sequencing of pharmacy law courses, supporting further investigation to identify the best practices in the delivery of pharmacy law education. Another deliberate focus should aim to more specifically determine how, if, and which specific modifications to delivery of pharmacy law education might ensure achievement of student learning outcomes and optimize PharmD graduates’ performance on standardized jurisprudence exams.

International use of objective structured clinical examinations in respiratory training: a European Respiratory Society early career member survey.

This international overview of the use of objective structured clinical examinations (OSCEs) in respiratory training highlights the heterogeneity in use between countries as well as the positive experience of OSCEs amongst users https://bit.ly/3Zee6zP.

CEERS Key Paper. II. A First Look at the Resolved Host Properties of AGN at 3 < z < 5 with JWST

We report on the host properties of five X-ray-luminous active galactic nuclei (AGN) identified at 3 < z < 5 in the first epoch of imaging from the Cosmic Evolution Early Release Science Survey. Each galaxy has been imaged with the JWST Near-Infrared Camera, which provides rest-frame optical morphologies at these redshifts. We also derive stellar masses and star formation rates for each host by fitting its spectral energy distribution using a combination of galaxy and AGN templates. We find that three of the AGN hosts have spheroidal morphologies, one is a bulge-dominated disk, and one is dominated by pointlike emission. None are found to show strong morphological disturbances that might indicate a recent interaction or merger event. When compared to a sample of mass-matched inactive galaxies, we find that the AGN hosts have morphologies that are less disturbed and more bulge-dominated. Notably, all four of the resolved hosts have rest-frame optical colors consistent with a quenched or poststarburst stellar population. The presence of AGN in passively evolving galaxies at z > 3 is significant because a rapid feedback mechanism is required in most semianalytic models and cosmological simulations to explain the growing population of massive quiescent galaxies observed at these redshifts. Our findings show that AGN can continue to inject energy into these systems after their star formation is curtailed, potentially heating their halos and preventing renewed star formation. Additional observations will be needed to determine what role this feedback may play in helping to quench these systems and/or maintain their quiescent state.

CEERS Epoch 1 NIRCam Imaging: Reduction Methods and Simulations Enabling Early JWST Science Results

We present the data release and data reduction process for the Epoch 1 NIRCam observations for the Cosmic Evolution Early Release Science Survey (CEERS). These data consist of NIRCam imaging in six broadband filters (F115W, F150W, F200W, F277W, F356W and F444W) and one medium-band filter (F410M) over four pointings, obtained in parallel with primary CEERS MIRI observations. We reduced the NIRCam imaging with the JWST Calibration Pipeline, with custom modifications and reduction steps designed to address additional features and challenges with the data. Here we provide a detailed description of each step in our reduction and a discussion of future expected improvements. Our reduction process includes corrections for known prelaunch issues such as 1/f noise, as well as in-flight issues including snowballs, wisps, and astrometric alignment. Many of our custom reduction processes were first developed with prelaunch simulated NIRCam imaging over the full 10 CEERS NIRCam pointings. We present a description of the creation and reduction of this simulated data set in the Appendix. We provide mosaics of the real images in a public release, as well as our reduction scripts with detailed explanations to allow users to reproduce our final data products. These represent one of the first official public data sets released from the Directors Discretionary Early Release Science (DD-ERS) program.

Timing of Diagnosis of Fetal Structural Abnormalities After the Introduction of Universal Cell-Free DNA in the Absence of First-Trimester Anatomical Screening

ABSTRACT Cell-free DNA (cfDNA) screens are now widely used for trisomy 21, 18, and 13 (and less often for sex-chromosome aberrations). In 2017, the Netherlands became the first country to implement genome-wide cfDNA as a first-tier screening test for chromosomal abnormalities. The use of this test for first-trimester screening subsequently increased from 32% to 45%, with 2% of women still choosing to have the combined test. Although the official purpose of these tests is for aneuploidy screening, studies demonstrate that at least one-fourth of structural abnormalities in fetuses can be detected during nuchal translucency (NT) measurement. Whether the routine addition of first-trimester anatomy screening (FTAS) would be effective in detecting severe fetal structural anomalies with low rates of false-positive results was felt to be important to address, to determine whether this should be an integral component of prenatal screening program. This study aimed to determine the gestational age at which fetal anomalies were detected and which anomalies detected by second-trimester anatomical screening could have theoretically been diagnosed via FTAS had this been performed on all women in the cohort. The data for this retrospective observational study were collected from pregnant women referred to the University Medical Center of Groningen Fetal Medicine Unit from 2017 through 2020. Women in the cohort were referred based on suspicion of fetal structural abnormalities following a dating ultrasound, or first- or second-trimester anatomy survey. First-trimester anatomy surveys were performed only in women with high-risk indications, including monochorionic twin pregnancy (or greater multiple pregnancy), first-degree relative of the fetus with structural abnormalities, more than 1 more distant relative with similar abnormalities, preexisting diabetes mellitus or first-trimester diagnosis of diabetes mellitus, high-titer thyroid-stimulating hormone receptor antibodies, or high radiation exposure of &gt;0.50 Gy. In the study, all information was collected regarding additional examinations, invasive testing, and pregnancy outcomes, including postpartum follow-up to confirm the diagnosis. Cases with an abnormal cfDNA result or increased risk for aneuploidy based on serum screening were not included, nor were “soft markers” for aneuploidy or variations of normal anatomy such as persistent left superior vena cava. In all, 547 pregnancies had second-trimester anomalies and were included in the analysis. A total of 13 pregnancies underwent FTAS, whereas the other 534 (97.6%) underwent only the dating ultrasound scan and second-trimester anatomy scanning. Average maternal age was 29 years, with a median body mass index of 25.1 kg/m2, and the mean gestational age at the time of the anatomical survey of 21.4 weeks. Of the 13 pregnancies that underwent FTAS, anomalies were confirmed in 12 fetuses, whereas 1 had edema that resolved. Overall, 492 fetuses (92.1%) had structural anomalies that were confirmed, and analysis was done to determine whether these would have been diagnosable in the first trimester. In all, 66 (13.4%) were classified as “always detectable” in the first trimester, 303 (61.6%) as “sometimes detectable,” and 123 (25.0%) as “never detectable.” The mean gestational age at diagnosis was 22.8 weeks. Limitations of the study include its hypothetical classification of abnormalities as “always,” “sometimes,” and “never,” based on the literature. However, the authors concluded that the introduction of an early anatomical survey together with noninvasive screening for aneuploidies is appropriate based on these results.

The BIALL Law Firm Library Survey 2022

AbstractIt goes without saying that few things are more important to information professionals than data, all the more so when that data relates to their own profession. Which is why this third edition of BIALL's Law Firm Survey is so welcome, providing, as it does, data on a range of different information departments working in the library space, while also drawing comparisons from the results of earlier surveys. Here Catherine Bowl and Diane Miller explain the process of compiling the survey, its findings, and the interesting trends it has highlighted.

Concordant and opposing effects of climate and land-use change on avian assemblages in California's most transformed landscapes.

Climate and land-use change could exhibit concordant effects that favor or disfavor the same species, which would amplify their impacts, or species may respond to each threat in a divergent manner, causing opposing effects that moderate their impacts in isolation. We used early 20th century surveys of birds conducted by Joseph Grinnell paired with modern resurveys and land-use change reconstructed from historic maps to examine avian change in Los Angeles and California's Central Valley (and their surrounding foothills). Occupancy and species richness declined greatly in Los Angeles from urbanization, strong warming (+1.8°C), and drying (-77.2millimeters) but remained stable in the Central Valley, despite large-scale agricultural development, average warming (+0.9°C), and increased precipitation (+11.2millimeters). While climate was the main driver of species distributions a century ago, the combined impacts of land-use and climate change drove temporal changes in occupancy, with similar numbers of species experiencing concordant and opposing effects.

Remnants of recent mergers in nearby early-type galaxies and their classification

ABSTRACTWe search for signatures of recent galaxy close interactions and mergers in a sample of 202 early-type galaxies in the local universe from the public SDSS Stripe82 deep images (μr ∼ 28.5 mag arcsec−2). Using two different methods to remove galaxies’ smooth and symmetric light distribution, we identify and characterize 11 distinct types of merger remnants embedded in the diffuse light of these early-type galaxies. We discuss how the morphology of merger remnants can result from different kinds of minor and major mergers, and estimate the fraction of early-type galaxies in the local universe with evidence of recent major (27 per cent) and minor (57 per cent) mergers. The merger fractions deduced are higher than in several earlier surveys. Among remnants, we find that shells are the dominant merger debris (54 per cent) associated with early-type galaxies, resulting from both major and minor mergers, with those characteristics of major mergers being significant (24 per cent of shell host galaxies). The most uncommon merger-related structures are boxy isophotes of the stellar distribution and the presence of disc fragments near the cores of galaxies. We develop a classification scheme for these fine structures that may be used to infer their likely genesis histories. The classification is primarily based on the mass ratios of the merged galaxies. This work, when combined with predictions from numerical simulations, indicates that most (if not all) early-type galaxies in the local Universe are continually evolving as a result of (minor) merger activities.

Impact of the Immediate Release of Clinical Information Rules on Health Care Delivery to Patients With Cancer.

The 21st Century Cures Act mandates the immediate release of clinical information (IRCI) to patients. Immediate sharing of sensitive test results to patients with cancer might have serious unintended consequences for patients and providers. A 22-question REDCap survey was designed by the Association of American Cancer Institutes Physician Clinical Leadership Initiative Steering Committee to explore oncology providers' opinions on IRCI policy implementation. It was administered twice in 2021 with a 3-month interval. A third survey with a single question seeking providers' opinions about their adaptation to the IRCI mandate was administered 1 year later to those who had responded to the earlier surveys. The data were analyzed using descriptive statistics such as chi-squared or Fisher's exact tests for categorical variables. The survey was sent to all Association of American Cancer Institutes cancer center members. In the first or second administration, 167 practitioners answered the survey; 31 responded to the third survey. Three quarters of the providers did not favor the new requirement for IRCI and 62% encountered questions from patients about results being sent to them without provider interpretation. Only half of the hospitals had a plan in place to deal with the new IRCI requirements. A third survey, for longitudinal follow-up, indicated a more favorable trend toward adoption of IRCI. IRCI for patients with cancer was perceived negatively by academic oncology providers after its implementation. It was viewed to be associated with higher levels of patient anxiety and complaints about the care delivered. Providers preferred to discuss test results with patients before release.

Paving the Road for Chimeric Antigen Receptor T Cells: American Society for Transplantation and Cellular Therapy 80/20 Task Force Consensus on Challenges and Solutions to Improving Efficiency of Clinical Center Certification and Maintenance of Operations for Commercially Approved Immune Effector Cell Therapies

As the number and type of regulatory authority-approved cellular therapies grow, clinical treatment centers face a heavy burden of duplicative documentation around initial qualification, ongoing auditing, and reporting, with overlapping requirements from each manufacturer to ensure safe use of their specific product, which in the United States are stipulated under individual Food and Drug Administration (FDA) Biologic License Applications. The American Society for Transplantation and Cellular Therapy (ASTCT) convened the 80/20 Task Force to consider challenges and potential solutions to these issues. The Task Force proposed that 80% of manufacturers' requirements for onboarding and ongoing operations of commercially available products could be standardized and streamlined. Task Force members interviewed dozens of stakeholders, including clinicians at large academic medical centers already using commercial and investigational immune effector cell (IEC) products, regulators, members of accrediting bodies and professional cellular therapy societies, and manufacturers of IEC therapies for oncologic indications. In November 2021, the Task Force organized and led virtual discussions in a public forum and at a private ASTCT 80/20 Workshop at the online AcCELLerate Forum, a cellular-therapy stakeholders' meeting organized by the ASTCT, National Marrow Donor Program (NMDP), and Center for International Blood and Marrow Transplant Research (CIBMTR). At the workshop, approximately 60 stakeholders worked to identify and prioritize common challenges in onboarding and maintenance of operations at clinical sites for commercial FDA-approved and future IEC therapies and ways to streamline the process. It was agreed that standardization would improve efficiency of onboarding, allowing more cost-effective, sustainable growth of approved IEC therapies at treatment centers, and facilitate wider access while maintaining safety and clinical success. This early but extensive survey of stakeholders resulted in 5 overarching suggestions for both established and emerging treatment centers: (1) eliminate duplication in accreditation and auditing of clinical sites; (2) define expectations for the education about and management of CAR-T therapy toxicities to potentially replace product-specific REMS programs; (3) streamline current REMS education, testing, and data reporting; (4) standardize information technology (IT) platforms supporting enrollment, clinical site-manufacturer communication, and logistics of maintaining chain of identity/chain of custody across multiple transportation steps; and (5) encourage the use of universal nomenclature by cell therapy manufacturers. Future discussions need to engage a broader range of stakeholders, including administrators, pharmacists, nurses, data coordinators, surgeons, pathologists, and those developing promising cellular therapies for solid tumors, as well as teams from smaller academic or community cancer center settings. Continued collaboration with stakeholders outside of clinical sites will include accrediting bodies/auditors, established and emerging cell therapy companies, software developers, professional societies, and the patients who receive these therapies. Active dialog with government regulators remains essential. Such joint efforts are critical as the number of IEC therapies for myriad oncologic and nononcologic indications grows.

Challenges in pastoral care practice in euthanasia: A concept mapping study among Dutch protestant pastors

This study explores the various difficulties that protestant pastors experience in the context of care for parishioners with a wish for euthanasia. In a reproducible and non-subjective way, using the concept mapping method, we cluster and rank-order 600 elements that pastors had mentioned as “difficult in caring for parishioners with a death wish” in an earlier survey study. The three clusters of items ranked as most difficult are connected with inappropriate care, doubts whether euthanasia in specific circumstances is justified, and disagreements between pastor and parishioner, including the emotional burden arising from those disagreements.