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End-of-life decision-making: community and medical practitioners' perspectives
M A Steinberg1, J M Najman, C M Cartwright
1Department of Social and Preventive Medicine, University of Queensland, Herston.
Objective:
To examine current attitudes and knowledge of the community and medical practitioners in Queensland to end-of-life decisions.
Design:
Cross-sectional survey by postal questionnaire.
Participants:
387 general practitioners and medical specialists and 910 community members from the Queensland electoral roll.
Main Outcome Measures:
Responses to five questions about end-of-life decision-making, and to legislative changes relating to such decisions.
Results:
The overall response rate for medical practitioners was 67% and for community members was 53%. 78% of community members (age adjusted) and 54% of doctors thought that a doctor should comply with a patient's request to turn off a life-support system; 68% of doctors through people would still ask to have their life ended even if pain were controlled, compared with 54% of community members; 70% of community members thought the law should be changed to allow active voluntary euthanasia, compared with 33% of doctors; and 65% of community members thought that a doctor should be allowed by law to assist a terminally ill person to die, but only 36% of doctors agreed. 79% of doctors and 75% of community members agreed that people would still ask for assistance to end their lives even if optimal palliative care were freely available.
Conclusion:
Community members supported greater choice and control over end-of-life decisions, while doctors were less supportive of some of the options canvassed. In a climate of community participation in health care decisions, it is important to better understand the basis and meaning of these different views. Further detailed research is recommended.