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Preferences of the Dutch general public for a good death and associations with attitudes towards end-of-life decision-making

Agnes van der Heide

Department of Public Health, University Medical Center Rotterdam, Rotterdam

Bregje D Onwuteaka-Philipsen

Department of Public and Occupational Health and Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam

Paul J van der Maas

Department of Public Health, University Medical Center Rotterdam, Rotterdam

Gerrit van der Wal

Department of Public and Occupational Health and Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam

Background: Euthanasia and other end-of-life decisions are acceptable to the large majority of the Dutch public. Insight in the relationships of such acceptance, with characteristics considered important for a ‘good death’, may contribute to the understanding of this liberal attitude. Method: Questionnaires were mailed to 1777 members of the Dutch public (response: 78%), containing questions relating to a good death, attitudes towards euthanasia, terminal sedation and increasing morphine, and demographics. Associations between characteristics of a good death and attitudes towards these end-of-life decisions were analysed. Findings: Characteristics that were considered important for a good death were: the possibility to say goodbye to loved ones (94%), dying with dignity (92%), being able to decide about end-of-life care (88%), and dying free of pain (87%). Acceptance of euthanasia, terminal sedation and increasing morphine were related to the wish to have a dignified death, and with concerns about burdening relatives with terminal care. Acceptance of euthanasia was also associated with the wish to be able to decide about medical end-of-life treatments and about the moment of death. Interpretation: Besides saying farewell and dying pain free and with dignity, many members of the Dutch public consider values of control and maintenance of independence as important for a good death.

Key Words: attitudes • end-of-life decisions • general public • good death • the Netherlands

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