RT Journal Article
SR Electronic
T1 Comparison of attitudes towards five end-of-life care interventions (active pain control, withdrawal of futile life-sustaining treatment, passive euthanasia, active euthanasia and physician-assisted suicide): a multicentred cross-sectional survey of Korean patients with cancer, their family caregivers, physicians and the general Korean population
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e020519
DO 10.1136/bmjopen-2017-020519
VO 8
IS 9
A1 Young Ho Yun
A1 Kyoung-Nam Kim
A1 Jin-Ah Sim
A1 Shin Hye Yoo
A1 Miso Kim
A1 Young Ae Kim
A1 Beo Deul Kang
A1 Hyun-Jeong Shim
A1 Eun-Kee Song
A1 Jung Hun Kang
A1 Jung Hye Kwon
A1 Jung Lim Lee
A1 Eun Mi Nam
A1 Chi Hoon Maeng
A1 Eun Joo Kang
A1 Young Rok Do
A1 Yoon Seok Choi
A1 Kyung Hae Jung
YR 2018
UL http://bmjopen.bmj.com/content/8/9/e020519.abstract
AB Objectives This study determined attitudes of four groups—Korean patients with cancer, their family caregivers, physicians and the general Korean population—towards five critical end-of-life (EOL) interventions—active pain control, withdrawal of futile life-sustaining treatment (LST), passive euthanasia, active euthanasia and physician-assisted suicide.Design and setting We enrolled 1001 patients with cancer and 1006 caregivers from 12 large hospitals in Korea, 1241 members of the general population and 928 physicians from each of the 12 hospitals and the Korean Medical Association. We analysed the associations of demographic factors, attitudes towards death and the important components of a ‘good death’ with critical interventions at EoL care.Results All participant groups strongly favoured active pain control and withdrawal of futile LST but differed in attitudes towards the other four EoL interventions. Physicians (98.9%) favoured passive euthanasia more than the other three groups. Lower proportions of the four groups favoured active euthanasia or PAS. Multiple logistic regression showed that education (adjusted OR (aOR) 1.77, 95% CI 1.33 to 2.36), caregiver role (aOR 1.67, 95% CI 1.34 to 2.08) and considering death as the ending of life (aOR 1.66, 95% CI 1.05 to 1.61) were associated with preference for active pain control. Attitudes towards death, including belief in being remembered (aOR 2.03, 95% CI 1.48 to 2.79) and feeling ‘life was meaningful’ (aOR 2.56, 95% CI 1.58 to 4.15) were both strong correlates of withdrawal of LST with the level of monthly income (aOR 2.56, 95% CI 1.58 to 4.15). Believing ‘freedom from pain’ negatively predicted preference for passive euthanasia (aOR 0.69, 95% CI 0.55 to 0.85). In addition, ‘not being a burden to the family’ was positively related to preferences for active euthanasia (aOR 1.62, 95% CI 1.39 to 1.90) and PAS (aOR 1.61, 95% CI 1.37 to 1.89).Conclusion Groups differed in their attitudes towards the five EoL interventions, and those attitudes were significantly associated with various attitudes towards death.