Multi-Ethnic Attitudes Toward Physician-Assisted Death in California and Hawaii

Abstract

Background: As aid-in-dying laws are gaining more public acceptance and support, it is important to understand diverse perceptions toward physician-assisted death (PAD). We compare attitudes of residents from California and Hawaii to identify variables that may predict attitudes toward PAD. Methods: A cross-sectional online survey of 1095 participants (a 75.8% survey completion rate) from California and 819 from Hawaii (a 78.4% survey completion rate). Data were collected between July through October 2015.Results: Majority of study participants in California (72.5%) and Hawaii (76.5%) were supportive of PAD. Only 36.8% of participants in Hawaii and 34.8% of participants in California reported completing advance directives. To better understand which subgroups were most in favor of PAD, data were analyzed using both recursive partitioning and stepwise logistic regression. Older participants were more supportive of PAD in both states. Also, all ethnic groups were equally supportive of PAD. Completion of advance directives was not a significant predictor of attitudes toward PAD. Persons who reported that faith/religion/spirituality was less important to them were more likely to support PAD in both states. Thus, the major influences on the attitudes to PAD were religious/spiritual views and age, not ethnicity and gender. Even in the subgroups least supportive of PAD, the majority supported PAD. Conclusions: This study shows that in the ethnically diverse states of California and Hawaii, faith/religion/ spirituality and age are major influencers of attitudes toward PAD and not ethnicity and gender. Even in the subgroups least supportive of PAD, the majority supports PAD.

Preferences for care towards the end of life when decision-making capacity may be impaired: A large scale cross-sectional survey of public attitudes in Great Britain and the United States

“…Periyakoil et al also, found that ethnicity and gender were not significant predictors. [29] In contrast, and as discussed above, the findings from this research revealed ethnicity as a strong predictor of choosing ‘measures to help me die peacefully’. Respondents who self-identified as ‘black’ or non-white were less likely to select this option.…”

“…[29] Periyakoil et al found that older respondents were significantly more supportive of PAD, and that those who reported spiritual or religious beliefs were significantly supportive of PAD. Periyakoil et al also, found that ethnicity and gender were not significant predictors.…”

“…[29] Another limitation is the lack of exploration of the impact of household income and socioeconomic status of respondents in light of the different healthcare systems in the USA and GB. Further research could investigate these issues in greater depth.…”

How California Prepared for Implementation of Physician-Assisted Death: A Primer

“…21 Research efforts should address new disparity concerns in California, which center on unequal access to PAD in patients who qualify but cannot afford medications, or lack resources or time to comply with safeguards. They should also examine the perception that PAD legalization represents devaluation of life by the health care system, and study normative effects of PAD legalization on attitudes about death and dying over time.…”

White matter microstructure, cognition, and molecular markers in fragile X premutation females

“…For example, an online survey conducted in California found that support for access to PAD varied by ethnicity, being highest among non-Hispanic white respondents (75.6%) and lowest among African American respondents (59.6%). 7 Continued open dialogue about these issues is needed. We agree with Dr. Sethi that health care providers need to be prepared to discuss these issues.…”