Attitudes of Flemish secondary school students towards euthanasia and other end-of-life decisions in minors

Background The aim of the study was to investigate attitudes of secondary school students
towards acceptability of requests by minors for end-of-life decisions (ELDs) with a possible
life-shortening effect: non-treatment decisions, potentially life-shortening alleviation of pain and
symptoms (APS) and euthanasia.
Methods A cross-sectional survey was conducted among second and fourth grades students in 20
secondary schools in Flanders, Belgium. An anonymous structured questionnaire was administered
to measure attitudes towards acceptability of requests for euthanasia and other ELDs, towards the
right to be informed about terminal prognosis and their own desire to be informed.
Results In total, 1769 students participated. In case of a terminal patient, 61% found a request for
euthanasia acceptable, 60% a request for APS and 69% a request for non-treatment decision,
compared with 18% (euthanasia) and 50% (APS) in case of a non-terminal patient. Acceptance was
highest among: boys, participants older than 14 years and participants from general as opposed to
technical and vocational education. Sixty-six per cent said the parents' opinion not being asked was
a circumstance that should hold back a physician from administering a lethal drug. Ninety per cent
of participants thought a minor has the right to be informed about terminal prognosis of a disease
while 78% would like to be informed themselves.
Conclusions Attitudes towards ELD requests varied with case and participant characteristics and
type of ELD. The studied adolescents have a clear wish to be informed about terminal prognosis.
Physicians and caregivers should adequately involve adolescents in decision making and tailor
prognosis-related information to their needs and level of competency.

Publication year:2009

Keywords:adolescents, attitude, decision making, euthanasia, patient participation, withholding treatment