New Study Is First To Look Beyond General Attitudes About End-Of-Life Options And Ask Older People What They Would Do

March 11, 1997

WASHINGTON, D.C.--It used to be that when you had a life-threatening illness you waited it out. Nowadays you have options. A new study in the just-released March issue of Psychology and Aging, published by the American Psychological Association (APA), looks at the factors that influence older adults end-of-life decisions.

Psychologist Victor Cicirelli, Ph.D., from Purdue University asked 388 older adults (ages 60 to 100) to respond to 17 different situations about end-of-life options. Each scenario depicted either a terminal or nonterminal condition accompanied by a low quality of life. Approximately one-third of the participants wanted someone else -- a family member, close friend or physician -- to make their end-of-life decision.

Why? Dr. Cicirelli believes that older adults have been socialized to see physicians as authority figures and may not feel that they can make their own decisions about their end-of-life options. Thus, they defer the decision to their physician. Another explanation is an older person's tendency to think that a family member will make decisions for them if needed. "An additional factor," says Dr. Cicirelli, "is the personality of these older individuals, particularly their belief that powerful others control their destiny."

"Earlier studies on end-of-life decisions looked at general attitudes about the options. My study asked older adults what they would do in situations where they had reduced ability to move, were dependent on someone else, were in pain and so forth. The results imply that older adults want the options, but a majority would rather live than end their life," says Dr. Cicirelli.

Other results of the study revealed that a minority (approximately one-tenth of the study participants) did want to end their life under low quality conditions, but there was no preference about which method they would use (suicide, assisted suicide or voluntary active euthanasia).

Dr. Cicirelli's research also found that the factors that influence older people's views regarding the various decision options at the end-of-life are not the same as those that influence suicide. Well-being, poor health, dependency, stress due to critical life events and lack of social support, all precursors of suicide, were unrelated to decisions to end life in these scenarios.

Article: "Relationship of Psychosocial and Background Variables to Older Adults' End-of-Life Decisions" by Victor G. Cicirelli, Ph.D., Purdue University, in Psychology and Aging, Vol. 12, No. 1, pp. 72-83.

(Full text available from the APA Public Affairs Office.)

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 142,000 researchers, educators, clinicians, consultants and students. Through its divisions in 49 subfields of psychology and affiliations with 58 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.

American Psychological Association

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