Life sustaining treatment at end-of-life in Japan: do the perspectives of the general public reflect those of the bereaved of patients who had died in hospitals?

OBJECTIVE: To compare the perspectives of the general public and of the bereaved of patients who had died in hospitals on life sustaining treatment (LST).
METHOD: Two self-administered questionnaire surveys were conducted in a city in Japan. The general public survey was mailed to a stratified sample of 1000 residents aged 20 and over, of which 419 (42%) responded. The bereaved survey was mailed to 427 family members of patients who had died in the city's 6 hospitals, of which 205 (48%) responded.
RESULTS: In the general public survey, 44% had discussed LST with their family; 30% thought physicians discussed them with the patient or family; if a family member were to have cancer 57% did not want LST, if frail, 69%. In the bereaved survey, 39% had discussed LST with the patient; 80% had the respondent's preferences followed by the physician; 23% had not wanted LST for cancer, 39% for a frail condition.
CONCLUSION: The LST preferences of a family member were known by less than half of the respondents in both surveys. When compared with the general public, the bereaved evaluated the physician's attitude more positively and the proportion who did not want LST was less.