End‐of‐life decision‐making: community and medical practitioners' perspectives

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Abstract
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 thought 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.