National Edition

More Americans say doctors should 'do everything' to keep patients alive

Published: Friday, Nov. 29 2013 10:45 a.m. MST

Most Americans believe there are situations in which patients should be allowed to die, but the number who believe medical professionals should do everything possible to keep patients alive is growing, according to a Pew Research Center survey.

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While most Americans believe that in some circumstances patients should be allowed to die, the minority who believe doctors should always do everything possible to keep someone alive has more than doubled since 1990, said a new survey from the Pew Research Center.

Two-thirds of those asked about end-of-life care for others said a patient should be allowed to die in certain cases; 31 percent said there are no such circumstances. In 1990, 15 percent said doctors and other health professionals should "always do everything possible to save a patient." In 2005, that number was 22 percent.

"That's almost a doubling in the share of adults who say medical staff should always do what they can," said Cary Funk, senior researcher at Pew. The change is two-pronged, she added, with fewer people taking the view intervening may not always be a good idea, along with more people who express an opinion at all. In earlier surveys, the percentage with no opinion or not responding was higher.

A different end

One of the things families haven't gotten their heads around is the change in how people are arriving at the end of their lives, said Dr. Joanne Lynn, director of the Altarum institute in Washington, D.C., and who was not involved in Pew's survey. That may contribute to the shift in views. For much of the past, people came to the end of their lives somewhat predictably. Barring an accident, they'd know they had a terminal illness and move into the category labeled "dying." "Once in that category, there were things that should be done," she said.

It's less clear now. People instead come down with multiple problems over an extended period of time and are still often pretty stable until a couple of weeks before they die, she said. "We've never put together a care system, a Social Security system, a financing system around that reality, but it's there."

That change may have changed how people view end-of-life issues. "There are so many things you can keep doing and sometimes they work. They work enough. Until a little something comes along that is big enough to topple those reserves," Lynn said.

The Pew survey of roughly 2,000 adults, conducted in March and April, also found Americans are closely divided on physician-assisted suicide, with 47 percent approving laws that would allow it, compared to 49 percent opposed. That has changed little from 2005. The percentage that believe a person in great pain with no hope of improvement has a right to take his own life rose to 62 percent from 1990's 55 percent.

Most of those surveyed noted circumstances in which they would want to halt their own treatment and be allowed to die: 57 percent if they were in a lot of pain and 52 percent if they had an incurable disease and depended entirely on someone else for care. On the other hand, just over a third said they would tell their doctors to do everything possible "to keep them alive, even in dire circumstances, such as having a disease with no hope of improvement and experiencing a great deal of pain," the report said. That's up from 28 percent in 1990.

Young adults in particular thought medical professionals should always do everything possible to save the life, said Funk. She was also interested to find that nearly half of those surveyed had had to think about some of the issues at least indirectly and sometimes very directly. Forty-seven percent said that through a close friend or in their family they had experienced the issues of someone in a coma or who had a terminal illness.

"It's not abstract as they're thinking about this kind of situation," Funk said.

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