Attitudes towards euthanasia in severely ill and dementia patients and cremation in Cyprus: a population-based survey

BMC Public Health

Elpidoforos S Soteriades²  Marianna Charalambous³  Michael A Talias³  Anastasios Televantos¹ 

[1] Cyprus Institute of Biomedical Sciences (CIBS), Athienitis Strovolos Park, 2A Elia Venezi Street, 2nd Fl. Office 206, 2042, Strovolos, Nicosia, Cyprus;Harvard School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Boston, MA, USA;Open University of Cyprus, Healthcare Management Program, 2252, Latsia, Nicosia, Cyprus

关键词: Cyprus;    Population survey;    Religion;    Cremation;    Euthanasia;   

Others  :  1161744
DOI  :  10.1186/1471-2458-13-878

 received in 2012-12-20, accepted in 2013-09-17,  发布年份 2013

【 摘 要 】

Background

Population studies on end-of-life decisions have not been conducted in Cyprus. Our study aim was to evaluate the beliefs and attitudes of Greek Cypriots towards end-of-life issues regarding euthanasia and cremation.

Methods

A population-based telephone survey was conducted in Cyprus. One thousand randomly selected individuals from the population of Cyprus age 20 years or older were invited to participate. Beliefs and attitudes on end-of-life decisions were collected using an anonymous and validated questionnaire. Statistical analyses included cross-tabulations, Pearson’s chi-square tests and multivariable-adjusted logistic regression models.

Results

A total of 308 males and 689 females participated in the survey. About 70% of the respondents did not support euthanasia for people with incurable illness and/or elders with dementia when requested by them and 77% did not support euthanasia for people with incurable illness and/or elders with dementia when requested by relatives. Regarding cremation, 78% were against and only 14% reported being in favor. Further statistical analyses showed that male gender, being single and having reached higher educational level were factors positively associated with support for euthanasia in a statistically significant fashion. On the contrary, the more religiosity expressed by study participants, the less support they reported for euthanasia or cremation.

Conclusions

The vast majority of Greek Cypriots does not support euthanasia for people with incurable illness and/or elders with dementia and also do not support cremation. Certain demographic characteristics such as age and education have a positive influence towards attitudes for euthanasia and cremation, while religiosity exerts a strong negative influence on the above. Family bonding as well as social and cultural traditions may also play a role although not comprehensively evaluated in the current study.

【 授权许可】

   
2013 Televantos et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Matlabi H, Parker SG, McKee K: The contribution of home-based technology to older people's quality of life in extra care housing. BMC Geriatr 2011, 31:11. 68
• [2]Gardiner P: A virtue ethics approach to moral dilemmas in medicine. J Med Ethics 2003, 29(5):297-302.
• [3]Emanuel EJ: Euthanasia: historical, ethical and empiric perspectives. Arch Intern Med 1994, 154:1890-1901.
• [4]Baume P, O’Malley E: Euthanasia attitudes and practices of medical practitioners. Med J Aust 1994, 161:137-144.
• [5]Cavlak U, Aslan UB, Gurso S: Attitudes of physiotherapists and physiotherapy students toward euthanasia: a comparative study. Adv Ther 2007, 24(1):135-145.
• [6]Duberstein PR, Conwell Y, Cox C: Attitudes toward self-determined death: a survey of primary care physicians. J Am Geriatr Soc 1995, 43(4):395-400.
• [7]Magnusson RS: Euthanasia: above ground, below ground. J Med Ethics 2004, 30(5):441-446.
• [8]Seidlitz L, Duberstein PR, Cox C: Attitudes of older people toward suicide and assisted suicide: an analysis of Gallup Poll findings. J Am Geriatr Soc 1995, 43(9):993-998.
• [9]Emanuel EJ, Daniels ER, Fairclough DL: The practice of euthanasia and physician-assisted suicide in the United States: adherence to proposed safeguards and effects on physicians. JAMA 1998, 12(6):507-513. 280
• [10]Parpa E, Mystakidou K, Tsilika E: The attitudes of Greek physicians and lay people on euthanasia and physician-assisted suicide in terminally ill cancer patients. Am J Hosp Palliat Care 2006, 23(4):297-303.
• [11]Emanuel EJ: Euthanasia: where the Netherlands leads will the world follow? No. Legalisation is a diversion from improving care for the dying. BMJ 2001, 322(7299):1376-1377.
• [12]Baume P, O'Malley E, Bauman A: Professed religious affiliation and the practice of euthanasia. J Med Ethics 1995, 21(1):49-54.
• [13]Curlin FA, Nwodim C, Vance JL, et al.: To die, to sleep: US physicians' religious and other objections to physician-assisted suicide, terminal sedation, and withdrawal of life support. Am J Hosp Palliat Care 2008, 25(2):112-120.
• [14]Gielen J, van den Branden S, Broeckaert B: Religion and nurses' attitudes to euthanasia and physician assisted suicide. Nurs Ethics 2009, 16(3):303-318.
• [15]Jones D: To Bury or Burn? Toward an ethic of cremation. JETS 2010, 53/2:335-347. 2
• [16]Cremation Association of North America (CANA) 2006. http://www.cremationassociation.org/ webcite
• [17]Glass AP, Samuel LF: A comparison of attitudes about cremation among black and white middle-aged and older adults. J Gerontol Soc Work 2011, 54(4):372-89.
• [18]Council of Europe: Steering Committee on Bioethics (CDBI): Replies to the questionnaire for member states relating to euthanasia. CDBI/INF. Strasbourg 2003, 8:1-66.
• [19]Panagiotarea A: Media and Euthanasia: A battle that must be won. A scientific symposium 2002. Apostoliki Diaconia; 2003:161-162. [Specific publication on the Issue of Euthanasia]
• [20]Cohen J, Marcoux I, Bilsen J, et al.: Trends in acceptance of euthanasia among the general public in 12 European countries (1981–1999). Eur J Public Health 2006, 16:663-669.
• [21]Cohen J, Marcoux I, Bilsen J, et al.: European public acceptance of euthanasia: Socio-demographic and cultural factors associated with the acceptance of euthanasia in 33 European countries. Soc Sci Med 2006, 63:743-756.
• [22]Kuuppelomäki M: Attitudes of cancer patients, their family members and health professionals toward active euthanasia. Eur J Cancer Care 2000, 9(1):16-21.
• [23]Kimsma GK, Van Leeuwen E: The role of family in euthanasia decision making. HEC Forum 2007, 19(4):365-73.
• [24]Rurup ML, Onwuteaka-Philipsen BD, Pasman HR, et al.: Attitudes of physicians, nurses and relatives towards end-of-life decisions concerning nursing home patients with dementia. Patient Educ Couns 2006, 61(3):372-80.
• [25]Davies D, Mates L: Encyclopedia of cremation. UK: Ashgate Publishing Ltd; 2005.