Determinants of favorable or unfavorable opinion about euthanasia in a sample of French cancer patients receiving palliative care

Abstract

BackgroundOpinion about euthanasia has been explored among the general population and recently in patients receiving palliative care. 96% of the French population declared themselves in favor of euthanasia while less of 50% of palliative care patients are. The aim of the present study was to explore and identify potential determinant factors associated with favorable or unfavorable opinion about euthanasia in a French population of cancer patients receiving palliative care.MethodsWe performed a cross-sectional study among patients in two palliative care units. Eligible patients were identified by the medical staff. Face-to-face interviews were performed by two investigators. Two groups were defined as favorable or unfavorable about euthanasia according to the answer on the specific question about patient opinion on euthanasia. A multivariate analysis including age, belief in God, chemotherapy and gender was built.ResultsSeventy-eight patients were interviewed. Median age was 60.5 years (range: 31–87.2). In univariate analysis, patients with a favorable opinion were most often under 60 years old (62 versus 38% unfavorable; p = 0.035), in couple (64 versus 35%; p = 0.032), didn’t believe in God (72 versus 28% were non-believers; p < 0.001) and had more frequently an history of chemotherapy treatment (58 versus 42% received at least one cycle of chemotherapy; p = 0.005). In a multivariate analysis, age < 60 years, absence of belief in God and an antecedent of chemotherapy were independently associated with a favorable opinion about euthanasia (OR = 0.237 [0.076–0.746]; p = 0.014, OR = 0.143 [0.044–0.469]; p = 0.001, and OR = 10.418 [2.093–51.853]; p = 0.004, respectively).ConclusionWe report here determinants of opinion about euthanasia in palliative care cancer patients. Thus, young patients who do not believe in God and have a history of chemotherapy treatment are more likely to request the discontinuation or restriction of their treatment. A better understanding of these determinants is essential for the development of information and/or interventions tailored to the palliative context.Electronic supplementary materialThe online version of this article (10.1186/s12904-018-0357-6) contains supplementary material, which is available to authorized users.

Legalisation of euthanasia and assisted suicide: advanced cancer patient opinions – cross-sectional multicentre study

“…Young patients who do not believe in God and have a history of chemotherapy treatment were more likely to request the discontinuation or restriction of their treatment. 8 In this study, the majority of patients (89.7%) were in favour of legalising proportionate sedation, that is, of a duration and depth appropriate for a so-called refractory symptom, and also in favour (82.2%) of deep and continuous sedation at the patient’s request, when he or she has decided to discontinue life-sustaining treatment in accordance with the current law. Therefore, the Claeys-Leonetti law is probably well adapted to the situations encountered by these patients and probably reflects patients' wishes.…”

“…16 As mentioned above, we identified the potential determining factors associated with a favourable or unfavourable opinion about euthanasia as age, belief in God and a medical history of chemotherapy. 8 In that study, only belief in God was a determining factor of holding an opinion against legalising euthanasia and assisted suicide. Therefore, the only determining factor identified in our study is a cultural factor that is independent of the other studied variables such as pain, anxiety, site of disease, treatments received, general health status, level of education and duration of disease.…”

“…A second single-centre study by our team reported determinants of opinions about euthanasia in palliative care patients with cancer. 8 This study concerns a national multicentre prospective survey on patients’ opinions about continuous sedation and legalising medical assistance in dying. Determinants associated with favourable and unfavourable opinions were explored.…”