PUBLIC-OPINION REGARDING END-OF-LIFE DECISIONS - INFLUENCE OF PROGNOSIS, PRACTICE AND PROCESS
PUBLIC-OPINION REGARDING END-OF-LIFE DECISIONS - INFLUENCE OF PROGNOSIS, PRACTICE AND PROCESS
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DOI：
10.1016/0277-9536(95)00057-e
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发表时间：
1995-12-01
影响因子：
5.4
通讯作者：
LOWY, FH
中科院分区：
文献类型：
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作者：
SINGER, PA;CHOUDHRY, S;LOWY, FH
本研究旨在探讨改变调查问题中的关键因素对公众对临终决定的看法的影响。这些因素是：（a）病人预后（可能与不大可能从疾病中康复）;（B）临终实践（放弃治疗与协助自杀与安乐死）;及（c）决策过程（有能力的病人与基于生前遗嘱的无能力的病人与基于家庭愿望的无能力的病人）。使用13项问卷调查了2019年18岁或以上加拿大人的代表性配额样本，其中12项问卷调查了对临终决定的态度。这些问题根据三个关键因素系统地变化：患者预后，临终实践和决策过程。其中一个项目评估受访者是否完成了生前遗嘱。在决定放弃对有能力的病人进行维持生命治疗的情况下，如果该人不太可能康复，公众的批准率为85%，如果该人可能康复，则为35%。在一个有能力的病人不太可能康复的情况下，公众赞成放弃维持生命的治疗的比例是85%，赞成协助自杀的比例是58%，赞成安乐死的比例是66%。在放弃对不太可能康复的患者进行维持生命治疗的情况下，对于有能力的患者，公众批准率为85%，对于通过生前遗嘱事先表达意愿的无能力患者，公众批准率为88%，对于根据家属要求无能力的患者，公众批准率为76%。这些关键因素的影响在所审查的其他案例中也是类似的。10%的加拿大人说他们已经完成了生前遗嘱。得出的结论是，病人的预后有一个主要的影响，临终实践的中度影响，和决策过程对公众舆论的影响较小的临终决定。
The purpose of this study was to examine the effect of changing key factors in survey questions on public opinion regarding end-of-life decisions. These factors were: (a) patient prognosis (likely vs unlikely to recover from the illness); (b) end-of-life practice (foregoing treatment vs assisted suicide vs euthanasia); and (c) and decision making process (competent patient vs incompetent patient based on living will vs incompetent patient based on family wishes). A representative quota sample of 2019 Canadians 18 years of age or older were surveyed using a 13-item questionnaire with 12 items eliciting attitudes towards end-of-life decisions. The questions were systematically varied according to three key factors: patient prognosis, end-of-life practice and decision making process. One item assessed whether respondents had completed a living will. In the case of a decision to forgo life-sustaining treatment in a competent patient, public approval was 85% if the person was unlikely to recover and 35% if the person was likely to recover. in the case of a competent patient unlikely to recover, public approval was 85% for forgoing life-sustaining treatment, 58% for assisted suicide, and 66% for euthanasia. In the case of forgoing life-sustaining treatment for a patient unlikely to recover, public approval was 85% for a competent patient, 88% for an incompetent patient who had expressed his/her wishes in advance through a living will, and 76% for an incompetent patient based on a family's request. The influence of these key factors was similar in other cases examined. Ten percent of Canadians said they had completed a living will. It was concluded that patient prognosis has a major effect, end-of-life practice a moderate effect, and decision making process a minor effect on public opinion regarding end-of-life decisions.