Why do older people oppose physician-assisted dying? A qualitative study

Malpas, Phillipa; Wilson, Maria K R; Rae, Nicola; Johnson, Malcolm H.

doi:10.1177/0269216313511284

Cited by 18 publications

(17 citation statements)

References 27 publications

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“…Some authors have suggested that the societal discourse about the increasing burden of ageing on care and pensions costs might be internalized by older adults who then behave accordingly, choosing a premature death as a preferable end-of-life option, when someone is considered to be or considers themselves to no longer be a useful or valuable member of society (Lamers and Williams 2016;Van Brussel et al 2014). In this context, the danger of the "slippery slope" (pressure on vulnerable elderly persons to opt for or accept hastened death), which was feared by opponents of the legalization of EU or PAS (Malpas et al 2014), might come from the negative societal discourse regarding aging and older adults. Media coverage about medically-assisted death (Van Brussel et al 2014), as well as negative personal experiences with the health care system or with the decline and dying process of relatives or friends, might also influence older adults' wish for PAS (Malpas et al 2012;Malpas et al 2014) and should therefore be examined in future research.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, the danger of the "slippery slope" (pressure on vulnerable elderly persons to opt for or accept hastened death), which was feared by opponents of the legalization of EU or PAS (Malpas et al 2014), might come from the negative societal discourse regarding aging and older adults. Media coverage about medically-assisted death (Van Brussel et al 2014), as well as negative personal experiences with the health care system or with the decline and dying process of relatives or friends, might also influence older adults' wish for PAS (Malpas et al 2012;Malpas et al 2014) and should therefore be examined in future research.…”

Section: Discussionmentioning

confidence: 99%

“…However, most of them used medical records (Steck et al 2014), or interviewed physicians (Jansen-van der Weide et al 2005), probably because the latter have the responsibility of justifying and deciding if the requirements for granting a request are met. Therefore, studies rarely asked the opinion of older adults, especially those living in the community (Lamers and Williams 2016;Malpas et al 2014).…”

Section: Introductionmentioning

confidence: 99%

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Religiosity and the Wish of Older Adults for Physician-Assisted Suicide

et al. 2018

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In industrialized countries, population ageing is associated with intense discussions on the issue of dying with dignity. Some countries have legalized assisted suicide and authorized physicians to provide the knowledge and/or means for suffering patients to end their life. The goal of this study was to ascertain if religiosity could be a predicting factor of older adults' wish for physician-assisted suicide (PAS). A sample of 216 men and women over 60 years (M = 72.5) answered the following question: "Would you disagree or agree with assisted suicide for yourself if you were very sick and would die in the near future?" They also completed questionnaires on religiosity, ageism and death anxiety. A regression analysis showed that religiosity explained a significant (F(1211) = 19.62; p < 0.001) proportion (7.7%) of the variance in the wish for PAS (full model R 2 = 0.17). Religiosity seems to reduce the likelihood that older adults would ask for PAS if they had a terminal illness, while ageism and death anxiety seemed to have the opposite effect. Health professionals and legislators must be aware that psychosocial and spiritual variables have an important influence on the wish for PAS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Religiosity and the Wish of Older Adults for Physician-Assisted Suicide

et al. 2018

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“…This generation, on average less educated and raised during the difficult times of World War II, also exhibits in later life withdrawn and observant characteristics, recognizing one's own role in society as less autonomous, more hierarchically organized, and prescriptively directed along rigid structural values (Hanse & Leuty, 2012). However, such cultural explanations must also be integrated with the physical decline of the older-old respondents, who are typically affected by the worst health conditions and often suffer disability impairments, therefore potentially fearing involuntary euthanasia and abuses if physician-assisted dying were legalized (Appelbaum, 2016;Buiting et al, 2012;Malpas et al, 2014;Rietjens et al, 2012;Shariff, 2012).…”

Section: Discussionmentioning

confidence: 99%

Attitudes Toward Active Voluntary Euthanasia Among Community-Dwelling Older Subjects

Poli

2018

Sage Open

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The major extension of late-life expectancy has increased the significance of end-of-life issues, particularly among elderly people, considering both the role of medical practices in shaping and defining dying trajectories and the differences in national laws and in public attitudes about preservation of self-dignity and removal of pain in death. Avoiding a prolonged, painful, and undignified death provides for many a rationale for euthanasia. On the contrary, the fear of increased pressure to end one's life prematurely and of potential abuses became often the main argument of opposition among vulnerable groups, like older people, especially when suffering from disability, chronic diseases, and lacking of autonomy. Through a representative cross-sectional survey, we studied 1,782 community-dwelling over-65s residents in Genoa (Italy), examining with bivariate and binary logistic regression analysis their attitudes toward active voluntary euthanasia (AVE), and exploring associations with sociodemographic characteristics, health and socioeconomic conditions, ideological orientations, and cultural practices. About 39.9% of our sample fully disagreed with AVE, 26.7% expressed tolerance, and 35.2% agreed completely. Results showed significant associations of different attitudes toward AVE with cultural values and moral practices, as well as with health and disability conditions, evidencing increasing full rejection toward AVE among over-75s profiles (46.3%). Our results suggest major intergenerational differences among older people, showing significant cultural change in attitudes toward endof-life issues. If and to the extent that older age plays a role, it is rather still strongly associated with rejection than with acceptance of AVE.

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“…Suicide in late life is known to be complex and multifactorial. Some factors have been found to influence both types of suicides in the elderly, such as constricted social networks (loneliness, social exclusion, bereavement), mood disorders and cognitive impairment [10][11][12][13]. It has been found in recent systematic reviews that physical illness and functional impairment are important suicide risk factors in the elderly.…”

Section: Introductionmentioning

confidence: 99%