Attitudes on end-of-life care and advance care planning in the lesbian and gay community.
Gay men and lesbians have special interests in documenting their preferences regarding advance care planning and end-of-life care. A 64-item survey instrument was developed to ascertain the preferences of this community regarding approaches to end-of-life care, viewpoints on physician-assisted suicide (PAS) and euthanasia, and practices regarding advance care planning. The survey was completed by 575 participants recruited through community-based health care and social service organizations serving the lesbian and gay community, primarily in the New York metropolitan area. Respondents represent a diverse group of women (36%) and men (63%) from various age, racial/ethnic, and religious/spiritual backgrounds; 10% were human immunodeficiency virus (HIV)-positive. Respondents' perspectives on end-of-life care are generally consistent with findings from other attitudinal studies of U.S. adults: a majority supported legalization of PAS and preferred a palliative approach to end-of-life care. However, the gay community sample revealed even stronger support for assisted suicide and palliative care. Although respondents completed advance directives at a higher rate than adults generally, the legal importance for gay men and lesbians to execute directives should encourage health care providers and community organizations to assume a larger educational role on advance care planning. Results confirm other reports on the need to address provider communication skills. It is speculated that the HIV epidemic was a major influence behind these results because of the overwhelming personal impact of the epidemic on most gay men and lesbians during the past two decades.
Stein
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HIV Professional Development Project, New York Academy of Medicine, New York, New York, USA. HealthDec@aol.com
Bonuck
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D000328:Adult; D016223:Advance Directives / Q000331:legislation & jurisprudence / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D001294:Attitude to Health; D001727:Bisexuality / Q000523:psychology*; D003657:Decision Making; D005260:Female; D015658:HIV Infections / Q000523:psychology; D006291:Health Policy / Q000331:legislation & jurisprudence; D018452:Homosexuality, Female / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009519:New York City; D010353:Patient Education as Topic; D017236:Suicide, Assisted / Q000331:legislation & jurisprudence; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000331:legislation & jurisprudence / Q000523:psychology* / Q000592:standards*