PUBLIC-OPINION REGARDING END-OF-LIFE DECISIONS - INFLUENCE OF PROGNOSIS, PRACTICE AND PROCESS

The purpose of this study was to examine the effect of changing key fa ctors in survey questions on public opinion regarding end-of-life deci sions. These factors were: (a) patient prognosis (likely vs unlikely t o recover from the illness); (b) end-of-life practice (foregoing treat ment vs assisted suicide vs euthanasia); and (c) and decision making p rocess (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 dec ision making process. One item assessed whether respondents had comple ted a living will. In the case of a decision to forgo life-sustaining treatment in a competent patient, public approval was 85% if the perso n was unlikely to recover and 35% if the person was likely to recover. in the case of a competent patient unlikely to recover, public approv al was 85% for forgoing life-sustaining treatment, 58% for assisted su icide, 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 expres sed his/her wishes in advance through a living will, and 76% for an in competent patient based on a family's request. The influence of these key factors was similar in other cases examined. Ten percent of Canadi ans said they had completed a living will. It was concluded that patie nt prognosis has a major effect, end-of-life practice a moderate effec t, and decision making process a minor effect on public opinion regard ing end-of-life decisions.