End-of-life decision-making: A cross-sectional study on knowledge and views of the Dutch general public

Physician-assisted dying (PAD) has been legal in the Netherlands since 2002. We examined public knowledge of PAD regulation and views on self-determination at the end of life. A cross-sectional survey among citizens aged ≥16 (N = 1,456) included 10 knowledge items and 18 statements on termination of life on request. Knowledge scores were calculated; exploratory factor analysis and linear regressions examined underlying constructs and associations with sociodemographic factors. Respondents answered on average five of ten knowledge questions correctly (response 75%; N = 1,097). Sixty‑eight percent agreed that everyone should have the right to euthanasia or assisted suicide. Four factors explained 60% of variance; most statements loaded on a self‑determination factor. Higher age, education, and no migration background were associated with greater knowledge and appreciation for self-determination; being female and non-religious also with stronger appreciation. Public knowledge of PAD's legal framework remains limited, while most citizens value self-determination, influenced by sociodemographic and cultural factors.