End-of-life preferences of the general public: Results from a Japanese national survey

Lee Andrew Kissane, Baku Ikeda, Reiko Akizuki, Shoko Nozaki, Kimio Yoshimura, Naoki Ikegami

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: To determine under different End-of-Life (EoL) scenarios the preferences of the general public for EoL care setting and Life-sustaining-Treatments (LST), and to develop a new framework to assess these preferences. Method: Using a 2-stage, geographical cluster sampling method, we conducted a postal survey across Japan of 2000 adults, aged 20+. Four EoL scenarios were used: cancer, cardiac failure, dementia and persistent vegetative state (PVS). Results: We received 969 valid responses (response rate 48.5%). Preference for EoL care setting varied by illness with those wishing to spend EoL at home only 39% for cancer, 22% for cardiac failure, and 10-11% for dementia and PVS. Preference for LST differed by scenario and treatment type. In cancer, cardiac failure and dementia, about half to two thirds expressed a preference for antibiotics and fluid drip infusion but few for nasogastric (NG) tube feeding, percutaneous endoscopic gastrostomy (PEG), ventilation or cardiopulmonary resuscitation (CPR). Although our models accounted for only 3-9% of the variance, preferences to receive LST were associated with preference to spend EoL in hospital for cancer and cardiac failure but not dementia. Conclusions: Few people preferred to die at home, while a preference for hospital was largely determined by factors other than preference for LST.

Original languageEnglish
JournalHealth Policy
DOIs
Publication statusAccepted/In press - 2014 Jul 21

Keywords

  • Dementia, primary senile degenerative
  • Japan
  • Life support care
  • Palliative care
  • Public opinion
  • Terminal care

ASJC Scopus subject areas

  • Health Policy

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