RT Journal Article
SR Electronic
T1 Attitudes of cancer patients, family caregivers, oncologists and members of the general public toward critical interventions at the end of life of terminally ill patients
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP cmaj.110020
DO 10.1503/cmaj.110020
A1 Young Ho Yun
A1 Kyung Hee Han
A1 Sohee Park
A1 Byeong Woo Park
A1 Chi-Heum Cho
A1 Sung Kim
A1 Dae Ho Lee
A1 Soon Nam Lee
A1 Eun Sook Lee
A1 Jung Hun Kang
A1 Si-Young Kim
A1 Jung Lim Lee
A1 Dae Seog Heo
A1 Chang Geol Lee
A1 Yeun Keun Lim
A1 Sam Yong Kim
A1 Jong Soo Choi
A1 Hyun Sik Jeong
A1 Mison Chun
YR 2011
UL http://www.cmaj.ca/content/early/2011/05/30/cmaj.110020.abstract
AB Background Whereas most studies have focused on euthanasia and physician-assisted suicide, few have dealt comprehensively with other critical interventions administered at the end of life. We surveyed cancer patients, family caregivers, oncologists and members of the general public to determine their attitudes toward such interventions. Methods We administered a questionnaire to four groups about their attitudes toward five end-of-life interventions — withdrawal of futile life-sustaining treatment, active pain control, withholding of life-sustaining measures, active euthanasia and physician-assisted suicide. We performed multivariable analyses to compare attitudes and to identify socio-demographic characteristics associated with the attitudes. Results A total of 3840 individuals — 1242 cancer patients, 1289 family caregivers and 303 oncologists from 17 hospitals, as well as 1006 members of the general Korean population — participated in the survey. A large majority in each of the groups supported withdrawal of futile life-sustaining treatment (87.1%–94.0%) and active pain control (89.0%–98.4%). A smaller majority (60.8%–76.0%) supported withholding of life-sustaining treatment. About 50% of those in the patient and general population groups supported active euthanasia or physician-assisted suicide, as compared with less than 40% of the family caregivers and less than 10% of the oncologists. Higher income was significantly associated with approval of the withdrawal of futile life-sustaining treatment and the practice of active pain control. Older age, male sex and having no religion were significantly associated with approval of withholding of life-sustaining measures. Older age, male sex, having no religion and lower education level were significantly associated with approval of active euthanasia and physician-assisted suicide. Interpretation Although the various participant groups shared the same attitude toward futile and ameliorative end-of-life care (the withdrawal of futile life-sustaining treatment and the use of active pain control), oncologists had a more negative attitude than those in the other groups toward the active ending of life (euthanasia and physician-assisted suicide).