[Patient living wills in Germany: conditions for their increase and reasons for refusal]

Abstract

Objectives: There is few data about how many people in Germany have deposited a living will or intend to do so. Most studies report distributions among patients, medical doctors or clinical personal. It is unclear, which pre-clinical conditions endorse the distribution of living wills. We were interested in which social contexts contribute to refusal of depositing a living will.

Method: In two representative surveys with 400 and with 1023 adults, who were between 16 and 92 years old. Within both two multiple-purpose surveys it was assessed whether a living will was available, and if not, whether respondents planned or objected to do so.

Results: About 10 percent of adults in Germany had deposited a living will pre-clinically. About fifty percent object to depositing a living will. Logistic regression analyses revealed that the distribution and acceptance of living will deposition depends on chronological age and personal experience with death and dying, even after statistically controlling for effects of socio-economic variables (education, income, household size). Adults are more likely to object to depositing a living will, if they are below 50 years old, do not eat healthy food, do no sports, have low income, and have not experienced death of a relative or acquaintance during the past year.

Conclusion: Acceptance of living will deposition depends in the pre-clinical phase of life on subjective experience related to medical end-of-life treatment. If people are confronted with death and dying in their social world, they will be more willing to consider their personal preference of end-of-life treatment.