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. 2018 Jul 31;16(1):152.
doi: 10.1186/s12955-018-0985-9.

Euthanasia, religiosity and the valuation of health states: results from an Irish EQ5D5L valuation study and their implications for anchor values

Luke Barry  1 , Anna Hobbins  2 , Daniel Kelleher  1 , Koonal Shah  3 , Nancy Devlin  3 , Juan Manuel Ramos Goni  4 , Ciaran O'Neill  5
Affiliations

Euthanasia, religiosity and the valuation of health states: results from an Irish EQ5D5L valuation study and their implications for anchor values

Luke Barry et al. Health Qual Life Outcomes. .

Abstract

Background: The Quality Adjusted Life Year influences the allocation of significant amounts of healthcare resources. Despite this surprisingly little research effort has been devoted to analysing how beliefs and attitudes to hastening death influence preferences for health states anchored at "dead" and "perfect health". In this paper we examine how, inter alia, adherence to particular religious beliefs (religiosity) influences attitudes to euthanasia and how, inter alia, attitudes to euthanasia influences the willingness to assign worse than dead (WTD) values to health states using data collected as part of the Irish EQ5D5L valuation study.

Methods: A sample of 160 respondents each supplied 10 composite time trade-off valuations and information on religiosity and attitudes to euthanasia as part of a larger national survey. Data were analysed using a recursive bivariate probit model in which attitudes to euthanasia and willingness to assign WTD values were analysed jointly as functions of a range of covariates.

Results: Religiosity was a significant determinant of attitudes to euthanasia and attitudes to euthanasia were a significant determinant of the likelihood of assigning WTD values. A significant negative correlation in errors between the two probit models was observed indicative of support for the hypothesis of endogeneity between attitudes to euthanasia and readiness to assign WTD values.

Conclusion: In Ireland attitudes and beliefs play an important role in understanding health state preferences. Beyond Ireland this may have implications for: the construction of representative samples; understanding the values accorded health states and; the frequency with which value sets must be updated.

Keywords: Anchor states; EQ5D5L; Euthanasia; Ireland; Religion; Worse than dead.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval for the study was granted by NUI Galway Ethics Committee (application number 15/JAN/04).

Consent for publication

Not applicable.

Competing interests

LB, AH and CON report grants from Health Research Board, grants from The EuroQol Research Foundation. KS and ND report grants from Office of Health Economics, outside the submitted work; and is a member of the EuroQol Group (developers of the EQ-5D family of instruments). JMRG is a member of EuroQol Group and a freelancer working for EuroQol Research Foundation. DK has no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Proportion of those in favour or against euthanasia (see scenario below) across religiosity
See this image and copyright information in PMC

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