Attitudes on end-of-life care and advance care planning in the lesbian and gay community

J Palliat Med. 2001 Summer;4(2):173-90. doi: 10.1089/109662101750290218.


Gay men and lesbians have special interests in documenting their preferences regarding advance care planning and end-of-life care. A 64-item survey instrument was developed to ascertain the preferences of this community regarding approaches to end-of-life care, viewpoints on physician-assisted suicide (PAS) and euthanasia, and practices regarding advance care planning. The survey was completed by 575 participants recruited through community-based health care and social service organizations serving the lesbian and gay community, primarily in the New York metropolitan area. Respondents represent a diverse group of women (36%) and men (63%) from various age, racial/ethnic, and religious/spiritual backgrounds; 10% were human immunodeficiency virus (HIV)-positive. Respondents' perspectives on end-of-life care are generally consistent with findings from other attitudinal studies of U.S. adults: a majority supported legalization of PAS and preferred a palliative approach to end-of-life care. However, the gay community sample revealed even stronger support for assisted suicide and palliative care. Although respondents completed advance directives at a higher rate than adults generally, the legal importance for gay men and lesbians to execute directives should encourage health care providers and community organizations to assume a larger educational role on advance care planning. Results confirm other reports on the need to address provider communication skills. It is speculated that the HIV epidemic was a major influence behind these results because of the overwhelming personal impact of the epidemic on most gay men and lesbians during the past two decades.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Advance Directives / legislation & jurisprudence
  • Advance Directives / psychology*
  • Aged
  • Aged, 80 and over
  • Attitude to Death*
  • Attitude to Health*
  • Bisexuality / psychology*
  • Decision Making
  • Female
  • HIV Infections / psychology
  • Health Policy / legislation & jurisprudence
  • Homosexuality, Female / psychology*
  • Homosexuality, Male / psychology*
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment
  • New York City
  • Patient Education as Topic
  • Suicide, Assisted / legislation & jurisprudence
  • Surveys and Questionnaires
  • Terminal Care / legislation & jurisprudence
  • Terminal Care / psychology*
  • Terminal Care / standards*