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公众对医疗协助死亡和姑息治疗的关注。

Public interest in medical assistance in dying and palliative care.

作者信息

Cheng Emily YiQin, Mah Kenneth, Al-Awamer Ahmed, Pope Ashley, Swami Nadia, Wong Joanne L, Mathews Jean, Howell Doris, Hannon Breffni, Rodin Gary, Shapiro Gilla K, Li Madeline, Le Lisa W, Zimmermann Camilla

机构信息

Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.

Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

BMJ Support Palliat Care. 2022 Dec;12(4):448-456. doi: 10.1136/spcare-2022-003910. Epub 2022 Sep 28.

Abstract

OBJECTIVES

Medical assistance in dying (MAiD) is legal in an increasing number of countries, but there are concerns that its availability may compromise access to palliative care. We assessed public interest in MAiD, palliative care, both, or neither, and examined characteristics associated with this interest.

METHODS

We surveyed a representative sample of the adult Canadian public, accessed through a panel from May to June 2019. Weighted generalised multinomial logistic regression analyses were used to determine characteristics associated with interest in referral to palliative care, MAiD, or both, in the event of diagnosis with a serious illness.

RESULTS

Of 1362 participants who had heard of palliative care, 611 (44.8% weighted (95% CI 42.1% to 47.5%)) would be interested in both MAiD and palliative care, 322 (23.9% (95% CI 21.5% to 26.2%)) palliative care alone, 171 (12.3% (95% CI 10.5% to 14.1%)) MAiD alone and 258 (19.0% (95% CI 16.9% to 21.2%)) neither. In weighted multinomial logistic regression analyses, interest in both MAiD and palliative care (compared with neither) was associated with better knowledge of the definition of palliative care, older age, female gender, higher education and less religiosity; interest in palliative care alone was associated with better knowledge of the definition of palliative care, older age, female gender and being married/common law; interest in MAiD alone was associated with less religiosity (all p<0.05).

CONCLUSIONS

There is substantial public interest in potential referral to both MAiD and palliative care. Simultaneous availability of palliative care should be ensured in jurisdictions where MAiD is legal, and education about palliative care should be a public health priority.

摘要

目标

医疗协助死亡(MAiD)在越来越多的国家已合法化,但人们担心其可及性可能会影响姑息治疗的可及性。我们评估了公众对MAiD、姑息治疗、两者或两者皆无的兴趣,并研究了与这种兴趣相关的特征。

方法

我们对2019年5月至6月通过一个小组获取的加拿大成年公众代表性样本进行了调查。采用加权广义多项逻辑回归分析来确定在被诊断患有严重疾病的情况下,与对转介至姑息治疗、MAiD或两者的兴趣相关的特征。

结果

在1362名听说过姑息治疗的参与者中,611人(加权后为44.8%(95%可信区间42.1%至47.5%))对MAiD和姑息治疗都感兴趣,322人(23.9%(95%可信区间21.5%至26.2%))仅对姑息治疗感兴趣,171人(12.3%(95%可信区间10.5%至14.1%))仅对MAiD感兴趣,258人(19.0%(95%可信区间16.9%至21.2%))对两者都不感兴趣。在加权多项逻辑回归分析中,对MAiD和姑息治疗都感兴趣(与两者都不感兴趣相比)与对姑息治疗定义的更好了解、年龄较大、女性、高等教育程度和宗教信仰较少相关;仅对姑息治疗感兴趣与对姑息治疗定义的更好了解、年龄较大、女性和已婚/同居相关;仅对MAiD感兴趣与宗教信仰较少相关(所有p<0.05)。

结论

公众对可能转介至MAiD和姑息治疗都有浓厚兴趣。在MAiD合法的司法管辖区应确保同时提供姑息治疗,并且关于姑息治疗的教育应成为公共卫生的优先事项。

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