Preferences of the Dutch general public for a good death and associations with attitudes towards end-of-life decision-making

Background: Euthanasia and other end-of-life decisions are acceptable to the large majority of the Dutch public. Insight in the relationships of such acceptance, with characteristics considered important for a 'good death', may contribute to the understanding of this liberal attitude. Method: Questionnaires were mailed to 1777 members of the Dutch public (response: 78%), containing questions relating to a good death, attitudes towards euthanasia, terminal sedation and increasing morphine, and demographics. Associations between characteristics of a good death and attitudes towards these end-of-life decisions were analysed. Findings: Characteristics that were considered important for a good death were: the possibility to say goodbye to loved ones (94%), dying with dignity (92%), being able to decide about end-of-life care (88%), and dying free of pain (87%). Acceptance of euthanasia, terminal sedation and increasing morphine were related to the wish to have a dignified death, and with concerns about burdening relatives with terminal care. Acceptance of euthanasia was also associated with the wish to be able to decide about medical end-of-life treatments and about the moment of death. Interpretation: Besides saying farewell and dying pain free and with dignity, many members of the Dutch public consider values of control and maintenance of independence as important for a good death.