Decision | Belgium | Denmark | Netherlands | Sweden | Switzerland | Australia | ||||||
Case 1 | Case 2 | Case 1 | Case 2 | Case 1 | Case 2 | Case 1 | Case 2 | Case 1 | Case 2 | Case 1 | Case 2 | |
APS at patient’s request† | ||||||||||||
Roman Catholic | 95 | 98 | * | * | 93 | 97 | 78 | 88 | 82 | 89 | 94 | 96 |
Protestant | * | * | 87 | 98 | 93 | 99 | 88 | 93 | 82 | 89 | 95 | 98 |
Non-religious (specific philosophy) | 98 | 99 | 95 | 100 | 95 | 100 | 84 | 98 | 89 | 96 | 97 | 97 |
Non-religious (no specific philosophy) | 97 | 98 | 87 | 100 | 93 | 98 | 88 | 95 | 89 | 94 | 97 | 98 |
p Value | 0.134 | 0.670 | 0.313 | 0.055 | 0.916 | 0.218 | 0.136 | 0.058 | 0.017 | 0.063 | 0.153 | 0.130 |
APS on own initiative | ||||||||||||
Roman Catholic | 83 | 79 | * | * | 63 | 45 | 68 | 71 | 74 | 69 | 86 | 71 |
Protestant | * | * | 82 | 78 | 70 | 49 | 80 | 76 | 69 | 64 | 80 | 65 |
Non-religious (specific philosophy) | 83 | 83 | 87 | 81 | 67 | 45 | 84 | 78 | 74 | 70 | 92 | 79 |
Non-religious (no specific philosophy) | 81 | 76 | 78 | 77 | 67 | 47 | 78 | 74 | 79 | 72 | 87 | 65 |
p Value | 0.692 | 0.188 | 0.215 | 0.733 | 0.342 | 0.772 | 0.092 | 0.587 | 0.019 | 0.094 | 0.013 | 0.121 |
Terminal sedation at patient’s request† | ||||||||||||
Roman Catholic | 81 | 78 | * | * | 74 | 62 | 68 | 69 | 66 | 74 | 59 | 49 |
Protestant | * | * | 52 | 47 | 71 | 70 | 50 | 50 | 70 | 73 | 67 | 55 |
Non-religious (specific philosophy) | 87 | 85 | 49 | 54 | 75 | 80 | 62 | 61 | 78 | 78 | 70 | 54 |
Non-religious (no specific philosophy) | 84 | 80 | 56 | 52 | 71 | 66 | 56 | 55 | 76 | 76 | 72 | 66 |
p Value | 0.121 | 0.122 | 0.297 | 0.159 | 0.823 | 0.048 | 0.010 | 0.013 | 0.037 | 0.651 | 0.002 | <0.001 |
Terminal sedation on own initiative | ||||||||||||
Roman Catholic | 60 | 38 | * | * | 38 | 10 | 49 | 33 | 54 | 33 | 46 | 22 |
Protestant | * | * | 41 | 21 | 37 | 8 | 34 | 21 | 48 | 31 | 51 | 28 |
Non-religious (specific philosophy) | 63 | 43 | 50 | 31 | 49 | 16 | 36 | 14 | 43 | 25 | 50 | 29 |
Non-religious (no specific philosophy) | 57 | 32 | 42 | 26 | 36 | 11 | 40 | 21 | 56 | 35 | 53 | 26 |
p Value | 0.295 | 0.023 | 0.566 | 0.097 | 0.485 | 0.470 | 0.045 | 0.086 | 0.072 | 0.533 | 0.324 | 0.444 |
PAD at patient’s request† | ||||||||||||
Roman Catholic | 46 | 39 | * | * | 45 | 47 | 6 | 8 | 18 | 14 | 12 | 11 |
Protestant | * | * | 20 | 19 | 42 | 49 | 5 | 3 | 24 | 23 | 22 | 18 |
Non-religious (specific philosophy) | 81 | 79 | 38 | 35 | 65 | 64 | 7 | 4 | 29 | 43 | 30 | 27 |
Non-religious (no specific philosophy) | 65 | 65 | 25 | 26 | 50 | 61 | 9 | 7 | 40 | 33 | 29 | 29 |
p Value | <0.001 | <0.001 | 0.012 | 0.004 | 0.019 | <0.001 | 0.111 | 0.011 | <0.001 | <0.001 | <0.001 | <0.001 |
PAD on own initiative | ||||||||||||
Roman Catholic | 22 | 9 | * | * | 13 | 5 | 5 | 3 | 10 | 7 | 8 | 4 |
Protestant | * | * | 17 | 9 | 13 | 3 | 5 | 2 | 13 | 9 | 17 | 10 |
Non-religious (specific philosophy) | 41 | 26 | 35 | 22 | 15 | 5 | 4 | 2 | 7 | 4 | 24 | 14 |
Non-religious (no specific philosophy) | 33 | 15 | 21 | 14 | 13 | 4 | 6 | 2 | 18 | 11 | 19 | 10 |
p Value | <0.001 | <0.001 | 0.014 | 0.002 | 0.966 | 0.622 | 0.872 | 0.819 | 0.008 | 0.285 | <0.001 | 0.019 |
Values are the percentages probably or certainly agreeing to make a given end-of-life decision; p values are from Pearson χ2 test .
Case 1: the patient is drowsy or subcomatose and communication is not possible. You estimate the patient’s life expectancy (without chemotherapy) to be no more than 2 weeks. Pain can be adequately controlled, but the patient is extremely tired, short of breath and bedridden.
Case 2: the patient is clear headed and can still communicate. You estimate the patient’s life expectancy (without chemotherapy) to be no more than 2 weeks. The patient had pain that is difficult to control despite the use of high doses of analgesics.
*Only life-stance groups with more than 2% of respondents in national sample were retained in the analyses
†For case 1 (communication not possible) “at patient request” was defined as a request stated in an advanced directive.
APS, alleviation of pain/symptoms using drugs with a possible life-shortening effect; PAD, physician-assisted death.