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Comparison of attitudes towards five end-of-life care interventions (active pain control, withdrawal of futile lifesustaining 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

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Author(s)
Young Ho YunKyoung-Nam KimJin-Ah SimShin Hye YooMiso KimYoung Ae KimBeo Deul KangHyun-Jeong ShimEun-Kee SongJung Hun KangJung Hye KwonJung Lim LeeEun Mi NamChi Hoon MaengEun Joo KangYoung Rok DoYoon Seok ChoiKyung Hae Jung
Keimyung Author(s)
Do, Young Rok
Department
Dept. of Internal Medicine (내과학)
Journal Title
BMJ Open
Issued Date
2018
Volume
8
Issue
9
Abstract
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.
Keimyung Author(s)(Kor)
도영록
Publisher
School of Medicine (의과대학)
Citation
Young Ho Yun et al. (2018). Comparison of attitudes towards five end-of-life care interventions (active pain control, withdrawal of futile lifesustaining 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. BMJ Open, 8(9), e020519–e020519. doi: 10.1136/bmjopen-2017-020519
Type
Article
ISSN
2044-6055
Source
https://bmjopen.bmj.com/content/8/9/e020519
DOI
10.1136/bmjopen-2017-020519
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41772
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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