Chen Duan-Rung, Kuo Chun-Tung, Wu Kevin Chien-Chang
Institute of Health Behaviours and Community Sciences, National Taiwan University College of Public Health, Taipei, Taiwan.
Population Health Research Centre, National Taiwan University College of Public Health, Taipei, Taiwan.
BMJ Open. 2025 Jan 15;15(1):e089388. doi: 10.1136/bmjopen-2024-089388.
To examine the public's stance on physician-assisted dying (PAD) in Taiwan across different PAD scenarios and identify demographic and psychosocial factors associated with the levels of support.
Cross-sectional survey design. Independent variables included individual sociodemographic characteristics, healthcare professionals, perceived quality of life, formal caregiver experience, Patient Right to Autonomy Act (PRAA) awareness and advance care planning (ACP) preparedness.
An online survey of the general population in Taiwan was conducted in 2022.
A total of 3922 Taiwanese adults who completed all survey questions.
Agreement levels with PAD in three scenarios: terminal illnesses, unbearable non-terminal pain and severe cognitive impairments. Multivariate logistic regression was used to examine agreement with each PAD scenario as separate dependent variables in the first three models and overall agreement across all scenarios as the dependent variable in the fourth model.
High levels of public support for PAD were observed, with 86.2% supporting PAD for terminal illnesses, 79.2% for unbearable non-terminal pain and 72.6% for severe cognitive impairments. Support for PAD was associated with factors including younger age, male gender, lack of religious affiliation, a non-healthcare professional background, employment as a formal caregiver, lack of awareness of PRAA and higher preparedness in ACP.
The results indicate a potential cultural shift in Taiwan towards greater emphasis on individual autonomy in end-of-life decisions. There appears to be significant public support for developing legal frameworks in favour of PAD, carefully considering the psychosocial factors that highlight the importance of individual rights in end-of-life care.
探讨台湾民众在不同医师协助死亡（PAD）场景下对其的立场，并确定与支持程度相关的人口统计学和社会心理因素。
横断面调查设计。自变量包括个人社会人口学特征、医疗保健专业人员、感知生活质量、正式照护者经历、《病人自主权利法》（PRAA）知晓度和预先照护计划（ACP）准备情况。
2022年对台湾普通民众进行了一项在线调查。
共有3922名台湾成年人完成了所有调查问题。
在三种场景下对医师协助死亡的认同程度：晚期疾病、无法忍受的非晚期疼痛和严重认知障碍。在前三个模型中，多因素逻辑回归用于检验将每种医师协助死亡场景作为单独因变量的认同情况，在第四个模型中，将所有场景下的总体认同情况作为因变量。
观察到民众对医师协助死亡的支持率较高，86.2%的人支持晚期疾病情况下的医师协助死亡，79.2%支持无法忍受的非晚期疼痛情况下的医师协助死亡，72.6%支持严重认知障碍情况下的医师协助死亡。对医师协助死亡的支持与以下因素相关：年龄较小、男性、无宗教信仰、非医疗保健专业背景、担任正式照护者、不了解《病人自主权利法》以及较高的预先照护计划准备情况。
结果表明台湾可能出现文化转变，更加重视临终决策中的个人自主权。似乎有相当多的民众支持制定有利于医师协助死亡的法律框架，同时要仔细考虑那些凸显个人权利在临终关怀中重要性的社会心理因素。
