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The views of clergy regarding ethical controversies in care at the end of life
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CONTEXT: While religion often informs ethical judgments, little is known about the views of American clergy regarding controversial end-of-life ethical issues including allowing to die and physician-aid in dying or physician-assisted suicide (PAD/PAS).
OBJECTIVE: To describe the views of U.S. clergy concerning allowing to die and PAD/PAS.
METHODS: A survey was mailed to 1665 nationally representative clergy between 8/2014 to 3/2015 (60% response rate). Outcome variables included beliefs about whether the terminally ill should ever be "allowed to die" and moral/legal opinions concerning PAD/PAS.
RESULTS: Most U.S. clergy are Christian (98%). Clergy agreed that there are circumstances in which the terminally ill should be "allowed to die" (80%). A minority agreed that PAD/PAS was morally (28%) or legally (22%) acceptable. Mainline/Liberal Christian clergy were more likely to approve of the morality (56%) and legality (47%) of PAD/PAS, in contrast to all other clergy groups (6%-17%). Greater end-of-life medical knowledge was associated with moral disapproval of PAD/PAS (adjusted odds ratio [AOR], 1.51; 95% CI, 1.04 to 2.19), p=0.03). Those reporting distrust in healthcare were less likely to oppose legalization of PAD/PAS (AOR 0.93; 95% CI, 0.87 to 0.99, p<0.02). Religious beliefs associated with disapproval of PAD/PAS, included "life's value is not tied to the patient's quality of life" (AOR 2.12; 95% CI, 0.1.49 to 3.03, p<0.001) and "only God numbers our days" (AOR 2.60; 95% CI, 1.77 to 3.82, p<0.001).
CONCLUSION: Most U.S. clergy approve of "allowing to die" but reject the morality or legalization of PAD/PAS. Respectful discussion in public discourse should consider rather than ignore underlying religious reasons informing end-of-life controversies.
http://dx.doi.org/10.1016/j.jpainsymman.2017.05.009
Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 55»
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