Files
Abstract
Background: Informed end-of-life decision-making requires a high level of death literacy. We
still know little about the general population’s level of knowledge and its determinants.
Aim: To assess knowledge of the general population regarding the legal status and definitions
of various end-of-life practices, and to compare the level of knowledge according to individual
characteristics known to influence death literacy.
Design: A self-administered questionnaire featuring two evolving vignettes was used to
assess participants’ knowledge relating to the legal status of various end-of-life practices
and whether these practices are Medical Aid in Dying (MAiD), which is legal in Canada. The
questionnaire also assessed participants’ individual characteristics such as their experience
as caregivers for someone who received palliative care, their perception of health, and their
financial situation.
Setting/participants: Participants were community-based community-based Canadian adults
able to read French or English.
Results: In total, 27% of the participants associated the description of care withholding with
MAiD, 39% incorrectly associated the description of continuous palliative sedation with MAiD,
and 34% incorrectly indicated that the described intervention was illegal. Having cared for
someone who received palliative care, at a younger age, a higher level of education, and
having participated in advance care planning were associated with better knowledge regarding
end-of-life practices.
Conclusion: Gaps in knowledge about end-of-life practices exist in the general population,
they are associated with different individual characteristics and may limit citizens’ capacity to
engage in informed end-of-life decision-making. Community-based interventions adapted to
different audiences are essential to ensure a quality end-of-life for all.