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老年人对临终使用安乐死的态度:癌症与帕金森病。

Older adults' attitudes toward using Euthanasia at the end-of life: cancer vs. Parkinson's disease.

机构信息

Community Gerontology, The Max Stern Academic College of Emek Yezreel, Emek Yezreel, Israel.

Program in Gerontology, Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.

出版信息

Front Public Health. 2024 Jun 14;12:1393535. doi: 10.3389/fpubh.2024.1393535. eCollection 2024.

Abstract

BACKGROUND

There is a paucity of studies that compare older adults' attitudes toward Euthanasia in two different terminal illnesses. Moreover, these studies did not relate to potentially influencing psycho-social factors. The current study aimed to examine the impact of a diverse range of variables on attitudes among older adults toward Euthanasia in two medical conditions: cancer and Parkinson's disease.

METHODS

A total of 501 individuals aged 75 and above participated in the study. Attitudes toward Euthanasia were measured using vignettes which described two conditions: an 80-year-old man with metastatic cancer and another man in an advanced stage of Parkinson's disease. The questionnaire included measures of relevant experience (with a close family member or a friend dying from a terminal illness), self-efficacy, will to live, satisfaction with life, will to prolong life, fear of death and dying, social support, and psycho-social characteristics. The data were analyzed using hierarchical linear regression models.

RESULTS

A more positive attitude toward Euthanasia was found in the case of cancer compared to Parkinson's disease. Being a woman, having more years of education, lower level of religiosity, greater fear of death and dying and higher self-efficacy contributes to more favorable attitudes toward Euthanasia in both end-of life conditions.

CONCLUSIONS

The finding that attitudes toward Euthanasia are statistically significantly more positive in the case of cancer compared to Parkinson's disease can be attributed to the greater prevalence of cancer in the population, and to the public's awareness of the suffering associated with each of these medical conditions. Beyond the important role of the socio-demographic characteristics of gender, education, and religiosity, it appears that fear of death and dying and self-efficacy are important psychological factors in explaining attitudes toward Euthanasia in both illnesses among older people. These findings shed light on older adults' attitudes toward Euthanasia in debilitating illnesses.

摘要

背景

目前比较两种不同终末期疾病中老年人对安乐死态度的研究较少。此外,这些研究没有涉及到可能影响心理社会因素。本研究旨在探讨一系列不同变量对两种疾病(癌症和帕金森病)中老年人对安乐死态度的影响。

方法

共有 501 名 75 岁及以上的老年人参与了这项研究。使用描述两种情况的情景描述来衡量对安乐死的态度:一名 80 岁患有转移性癌症的男子和另一名处于帕金森病晚期的男子。问卷包括与终末期疾病相关的经验(与亲密的家庭成员或朋友去世)、自我效能感、生存意愿、生活满意度、延长生命的意愿、对死亡和濒死的恐惧、社会支持以及心理社会特征的测量。使用分层线性回归模型对数据进行分析。

结果

与帕金森病相比,癌症患者对安乐死的态度更为积极。女性、受教育年限较长、宗教信仰程度较低、对死亡和濒死的恐惧程度较高、自我效能感较高,这两种临终状况下对安乐死的态度更为有利。

结论

与帕金森病相比,癌症患者对安乐死的态度在统计学上更为积极,这可能归因于癌症在人群中的发病率较高,以及公众对这两种疾病的痛苦的认识。除了性别、教育和宗教信仰等重要的社会人口特征外,对死亡和濒死的恐惧以及自我效能感似乎是解释老年人对两种疾病安乐死态度的重要心理因素。这些发现为老年人在衰弱性疾病中对安乐死的态度提供了新的认识。

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Euthanasia and assisted suicide in neurological diseases: a systematic review.神经疾病中的安乐死与协助自杀:一项系统综述
Neurologia (Engl Ed). 2024 Mar;39(2):170-177. doi: 10.1016/j.nrleng.2024.01.007. Epub 2024 Jan 23.
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Advances in Neurodegenerative Diseases.神经退行性疾病的进展
J Clin Med. 2023 Feb 21;12(5):1709. doi: 10.3390/jcm12051709.
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Assisted suicide in patients with cancer.癌症患者的协助自杀。
ESMO Open. 2022 Feb;7(1):100349. doi: 10.1016/j.esmoop.2021.100349. Epub 2022 Jan 20.

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