The Ohio State University College of Medicine MSTP, Columbus, Ohio, USA; The Ohio State University College of Public Health, Columbus, Ohio, USA.
The Ohio State University Center for Bioethics, Columbus, Ohio, USA; The Ohio State University College of Medicine Division of Biomedical Education and Anatomy, Columbus, Ohio, USA.
J Pain Symptom Manage. 2021 Sep;62(3):559-569. doi: 10.1016/j.jpainsymman.2021.01.009. Epub 2021 Jan 22.
It is crucial that physicians understand differing attitudes toward euthanasia and which factors to consider when discussing end-of-life decisions with patients and families from diverse backgrounds.
To investigate how attitudes toward euthanasia differ among countries, how they change, and how economic, religious, and health-related factors affect these attitudes.
We analyzed attitudes toward euthanasia and economic, religious, and health-related indicators using longitudinal (1981-2018) World Values Survey (WVS) data. They included 62 countries with at least a 15-year, three-wave, time series (total n = 389,243 participants). Each national survey interviewed representative samples of adults (mean = 1405).
In the latest wave, The Netherlands had the most favorable views of euthanasia (10-point scale with 1 = least justifiable: mean = 7.47) and Jordan the least (mean = 1.50). Residents of 23 of 24 high-income countries came to view euthanasia as more justifiable, while residents of 12 of 38 middle- and low-income countries came to view it as less justifiable over time. The higher GDP per-capita at the time of survey, the more euthanasia was accepted (r = 0.703; P< 0.0001); the more important respondents viewed religion as being, the less euthanasia was accepted (r = -0.834; P< 0.0001); the higher life expectancy and the lower infant mortality were, the more euthanasia was accepted (r = 0.669; P< 0.0001/r = -0.716; P< 0.0001).
Euthanasia-related attitudes differ widely depending on the cultural context; changes over time varied in both directions; euthanasia-related attitudes were associated with economic, religious and health-related factors. With globalization increasing cultural diversity, these findings can inform physicians' communication about end-of-life decisions with patients and families from diverse backgrounds.
医生了解对安乐死的不同态度以及在与来自不同背景的患者和家属讨论临终决策时应考虑哪些因素至关重要。
调查不同国家对安乐死的态度差异、这些态度的变化以及经济、宗教和健康相关因素如何影响这些态度。
我们使用纵向（1981-2018 年）世界价值观调查（WVS）数据分析了对安乐死的态度以及经济、宗教和健康相关指标。这些数据包括至少有 15 年、三波、时间序列的 62 个国家（共有 389243 名参与者）。每个国家调查都对成年人进行了代表性抽样（平均 1405 人）。
在最新一轮调查中，荷兰对安乐死的看法最为有利（10 分制，1 分表示最不合理：平均值为 7.47），而约旦的看法最不合理（平均值为 1.50）。随着时间的推移，24 个高收入国家中有 23 个国家的居民认为安乐死更合理，而 38 个中高收入和低收入国家中有 12 个国家的居民认为安乐死更不合理。调查时人均 GDP 越高，接受安乐死的程度越高（r=0.703；P<0.0001）；受访者认为宗教越重要，接受安乐死的程度越低（r=-0.834；P<0.0001）；预期寿命越高，婴儿死亡率越低，接受安乐死的程度越高（r=0.669；P<0.0001/r=-0.716；P<0.0001）。
安乐死相关的态度因文化背景而异；随着时间的推移，变化的方向各不相同；安乐死相关的态度与经济、宗教和健康相关因素有关。随着全球化增加文化多样性，这些发现可以为医生与来自不同背景的患者和家属就临终决策进行沟通提供信息。
