A systematic review of older adults' request for or attitude toward euthanasia or assisted-suicide.
OBJECTIVES
Prevalence rates of death by euthanasia (EUT) and physician-assisted suicide (PAS) have increased among older adults, and public debates on these practices are still taking place. In this context, it seemed important to conduct a systematic review of the predictors (demographic, physical health, psychological, social, quality of life, religious, or existential) associated with attitudes toward, wishes and requests for, as well as death by EUT/PAS among individuals aged 60 years and over.


METHOD
The search for quantitative studies in PsycINFO and MEDLINE databases was conducted three times from February 2016 until April 2018. Articles of probable relevance (n = 327) were assessed for eligibility. Studies that only presented descriptive data (n = 306) were excluded.


RESULTS
This review identified 21 studies with predictive analyses, but in only 4 did older adults face actual end-of-life decisions. Most studies (17) investigated attitudes toward EUT/PAS (9 through hypothetical scenarios). Younger age, lower religiosity, higher education, and higher socio-economic status were the most consistent predictors of endorsement of EUT/PAS. Findings were heterogeneous with regard to physical health, psychological, and social factors. Findings were difficult to compare across studies because of the variety of sample characteristics and outcomes measures.


CONCLUSION
Future studies should adopt common and explicit definitions of EUT/PAS, as well as research designs (e.g. mixed longitudinal) that allow for better consideration of personal, social, and cultural factors, and their interplay, on EUT/PAS decisions.
['Castelli Dransart|Dolores Angela|DA|', 'Lapierre|Sylvie|S|', 'Erlangsen|Annette|A|0000-0003-3475-0558', 'Canetto|Silvia Sara|SS|', 'Heisel|Marnin|M|', 'Draper|Brian|B|0000-0003-1405-7932', 'Lindner|Reinhard|R|', 'Richard-Devantoy|Stephane|S|', 'Cheung|Gary|G|', 'Scocco|Paolo|P|', 'Gusmão|Ricardo|R|', 'De Leo|Diego|D|', 'Inoue|Ken|K|', 'De Techterman|Vincent|V|', 'Fiske|Amy|A|', 'Hong|Jin Pyo|JP|', 'Landry|Marjolaine|M|', 'Lepage|Andrée-Anne|AA|', 'Marcoux|Isabelle|I|', 'Na|Peter Jongho|PJ|', 'Neufeld|Eva|E|', 'Ummel|Deborah|D|', 'Winslov|Jan-Henrik|JH|', 'Wong|Christine|C|', 'Wu|Jing|J|0000-0002-4941-3370', 'Wyart|Marilyn|M|']
D000368:Aged D001290:Attitude D001291:Attitude of Health Personnel D001293:Attitude to Death D005065:Euthanasia D006801:Humans D008875:Middle Aged D011788:Quality of Life D012067:Religion D017236:Suicide, Assisted
older adults Attitudes euthanasia physician-assisted suicide decisions