Attitudes towards end-of-life decisions in case of long-term care dependency: a survey among the older population in Austria

Stolz, Erwin; Mayerl, Hannes; Waxenegger, Anja; Rásky, Éva; Freidl, Wolfgang

doi:10.1136/medethics-2016-103731

Cited by 8 publications

(10 citation statements)

References 18 publications

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“…Our study makes several contributions to the literature. While previous studies have explored attitudes towards euthanasia and AS in the general population [30,[36][37][38][39][40][41], there are -to the best of our knowledge-no previous studies that have investigated both attitudes and behaviours (actual and planned membership in a right-to-die organisation) in the same population in parallel. This strategy allows to assess the associations of EOL preferences and trust in social or public institutions not just with AS-related attitudes but also corresponding behaviours.…”

Section: Introductionmentioning

confidence: 99%

Associations of end-of-life preferences and trust in institutions with public support for assisted suicide evidence from nationally representative survey data of older adults in Switzerland

et al. 2020

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The legality of euthanasia and assisted suicide (AS) and nature of regulations of these practices remain controversial and the subject of lively debate among experts and the general public. Our study investigates attitudes and behaviours towards AS among older adults in Switzerland where the practice of AS has a relatively long history and remains rather unregulated. We aim to explore how individuals' preferences regarding their end of life, as well as individuals' trust in institutions involved in the practice or control of AS are associated with attitudes and behaviours towards AS. We analyse nationally representative data of adults aged 55 and over from wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) in Switzerland (n = 2,145). While large majorities supported current legal arrangements around AS in Switzerland (81.7%) and stated that they could consider AS for themselves under certain circumstances (61.0%), only a minority either was a member of a right-to-die organisation already (4.9%) or stated they were likely to become a member of such an organisation (28.2%). Stated preferences for control over the end of life and for maintaining essential capabilities at the end of life showed a positive association with AS-related attitudes and behaviours, whereas preferences for feeling socially and spiritually connected, as well as for not being a burden displayed a negative association with our outcomes. Higher levels of trust in one's relative were positively associated with both support for the legality of AS and potential use of AS. A positive association was also found between trust in the Swiss legal system and support for the legality of AS. By contrast, trust in religious institutions displayed a negative association with all five AS-related attitudes and behaviours. Similarly, trust in healthcare insurance companies was negatively associated with potential use of AS. Taken together, older adults were generally supportive towards current practices regarding AS. This approval appears to be closely related to individuals' preferences and, at different extends, to trust in social and public institutions with regard to end-of-life issues, which is relatively high in Switzerland.

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Section: Introductionmentioning

confidence: 99%

Associations of end-of-life preferences and trust in institutions with public support for assisted suicide evidence from nationally representative survey data of older adults in Switzerland

et al. 2020

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“…A higher level of education was consistently associated with a favorable attitude toward EUT or PAS in older adults (Buiting et al, 2012;Cicirelli, 1997Cicirelli, , 1998Koenig et al, 1996;Stolz, Mayerl, Waxenegger, Rásky, & Freidl, 2017) and with higher likelihood of death by PAS (Hedberg et al, 2003;Steck et al, 2016Steck et al, , 2018.…”

Section: Sociodemographic Predictorsmentioning

confidence: 93%

“…Older adults who scored high on ageism had significantly more favorable attitudes toward PAS than older adults who scored low on ageism. Similarly, older adults who had high concerns about ageing were more favorable with EUT/PAS for a severely care-dependent older person who wished to die (Stolz et al, 2017).…”

Section: Social Predictorsmentioning

confidence: 99%

“…A majority of studies indicated that religious older adults have less favorable opinions towards EUT or PAS than non-religious older adults (Blank et al, 2001b;Cicirelli et al, 1997Cicirelli et al, , 2000Espino et al, 2010;Hare et al, 2000;Lapierre et al, 2018;Mouton et al, 2000;Roesinger et al, 2018;Seidlitz et al, 1995;Stolz et al, 2017;Sullivan et al, 1998). Being unaffiliated or Protestants predicted acceptance of EUT or PAS as an end-of-life care option (Buiting et al, 2012;Cicirelli et al, 1998Cicirelli et al, , 2000Steck et al, 2016Steck et al, , 2018.…”

Section: Religious or Spiritual Beliefsmentioning

confidence: 99%

“…Only one study looked at potential association of care experiences of older adults and their expectations of familial help on their attitude toward EUT/PAS (Stolz et al, 2017).…”

Section: Social Predictorsmentioning

confidence: 99%

See 2 more Smart Citations

A systematic review of older adults’ request for or attitude toward euthanasia or assisted-suicide

Dransart

Lapierre

Erlangsen

et al. 2019

Aging & Mental Health

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Objectives: Prevalence rates of death by euthanasia (EUT) and physician-assisted suicide (PAS) have considerably increased in older adults, and public debates on these practices are still taking place. In this context, it seemed important to conduct a systematic review of the predictors (demographic, physical, psychological, social, quality of life, religious or existential) associated with attitudes toward, wishes and requests for, as well as death by EUT/PAS among individuals aged 60 years and over. Method: The search for quantitative studies in PsycINFO and MEDLINE databases was conducted three times until April 2018. Articles of probable relevance (n = 327) were assessed for eligibility. Studies that only presented descriptive data (n = 306) were excluded. Results: The review identified 21 studies with predictive analyses, but in only 4 did older adults face actual end-of-life decision making. Most studies (17) investigated attitudes toward EUT/PAS (9 through various hypothetical scenarios). Younger age, lower religiosity, higher education and socioeconomic status, were the most consistent predictors of endorsement of EUT/PAS. Findings were heterogeneous with regard to physical, psychological and social factors. Findings were difficult to compare across studies because of the large variety of outcomes measures and sample characteristics. Conclusion: Future studies should adopt common and explicit definitions of these concepts, as well as mixed longitudinal research designs that would allow for better consideration of various personal and social factors, and their interplays, on the decisionmaking process with regard to EUT/PAS.

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The role of language in suicide reporting: Investigating the influence of problematic suicide referents

Arendt

Scherr

Niederkrotenthaler

et al. 2018

Social Science & Medicine

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Attitudes towards end-of-life decisions in case of long-term care dependency: a survey among the older population in Austria

Abstract: Widespread concerns regarding long-term care dependency in old age should be addressed in information campaigns, and public discourse about ELDs should pay more attention to situations of long-term care dependency.

Cited by 8 publications

References 18 publications

Associations of end-of-life preferences and trust in institutions with public support for assisted suicide evidence from nationally representative survey data of older adults in Switzerland

Associations of end-of-life preferences and trust in institutions with public support for assisted suicide evidence from nationally representative survey data of older adults in Switzerland

A systematic review of older adults’ request for or attitude toward euthanasia or assisted-suicide

The role of language in suicide reporting: Investigating the influence of problematic suicide referents

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