Table 1 Q set and factor scores

1

It is not worthwhile devoting more and more NHS money to someone who is going to die soon anyway

2

We should support an individual patient's choice for treatments that give short life extensions

3

Treatments should be directed towards people who have a greater chance of survival

4

If a special case can be made for expensive treatments for people who are terminally ill, an equal case could be made for drugs which slow dementia, help preserve eye sight, or reduce disability in children

5

At the end of their life, patients should be cared for at home with a better quality of life rather than have aggressive and expensive treatments that will only extend life for a short period of time

6

If somebody wants to keep fighting until the last possible moment, they should be allowed to do so, regardless of cost

7

It's important to respect the wishes of patients who feel they should take every opportunity to extend their life because of their cultural or religious beliefs

8

Patients should have the right to refuse life-extending treatments if they choose

9

It is important to offer life-extending treatments to patients who have only recently found out that they are going to die soon

10

People should accept that if it's your time to die, it's your time

11

It is important to give a dying person and their family time to prepare for their death, put their affairs in order, make peace and say goodbyes

12

I would value life extending treatments only if patients get a meaningful length of time - not just a few weeks

13

I would place more value on end-of-life treatments than many medical treatments for non-terminal conditions

14

People who will die prematurely deserve to take priority over those who have non-life-threatening illnesses, even if it's not such a 'good' use of NHS money

15

Expensive drugs for people who are terminally ill and won’t benefit very much are not a good use of NHS money

16

It is human nature to want to preserve life and go on living for as long as we can - it is one of our most basic instincts

17

If a life-extending treatment for terminally ill patients is expensive, but the only treatment available, it should still be provided

18

It may not sound like much, but a few extra weeks or months might mean an awful lot to a family affected by a terminal illness

19

Life should only be extended if the patient’s quality of life during that time will be good

20

We all have the right to life

21

We all pay for the NHS so we should have a right to life-extending treatment when we need it

22

Real help and compassion should be about providing a death with dignity instead of more drugs to get a few more weeks or months out of a very sick body

23

A year of life is of equal value for everyone

24

You can't put a price on life

25

We should spend proportionately more on patients when we feel those patients have not had their fair innings - in terms of the length of their life or the quality of that life

26

It is wrong to raise hopes and expectations by making a special case for treatments that will only extend life by a short time

27

To extend life in a way that is beneficial to the patient is morally the right thing to do

28

If the means of helping someone live longer exists, it is morally wrong to deny them the treatment

29

Not giving access to life-extending medicine to a person with a terminal illness is the same as killing them

30

The NHS budget is like a cake. Lots of small portions will do no good but if they are too big only a few people benefit. The simple answer is not to pay for very expensive drugs which only benefit a few

31

Treatments that are very costly in relation to their health benefits should be withheld

32

People with a diagnosis of a terminal illness know that they will die early. Other people may not know in advance that they will die (e.g. patients with heart problems). It is unfair to give priority to those whose time of death is more likely to be known

33

End-of-life drugs are not a cure, they are life-prolonging. There is no point in delaying the inevitable for a short time

34

Patients at the end of life will grasp any slightest hope but that is not a good reason for the NHS to provide costly treatments that may extend life by a short time

35

NHS provision of life-extending treatments should be decided on the basis of their cost and health benefits

36

Treatments that provide a short life extension are not worth it - they are only prolonging the pain for the patient’s family/friends

37

All human life is precious

38

The health system should be about getting the greatest benefit overall for the population

39

Extending life for people with terminal illness is only postponing death

40

Life is sacred and if it is possible to preserve life, every effort should be made to do so

41

I wouldn’t want my life to be extended just for the sake of it - just keeping breathing is not life

42

Treating terminally ill patients as more 'worthy' of NHS money undervalues the health of other NHS patients

43

Everyone has a right to basic healthcare but there has to be limits and expensive, end-of-life, drugs are not basic care

44

An end-of-life treatment which extends life-expectancy by 3 months now, is more valuable than a treatment for a long-term illness which extends life-expectancy by 3 months in ten years time

45

New breakthroughs are made every day - where there’s life there’s hope

46

A few weeks of extra time is more valuable when patients only have a short time left

47

It's important to provide life-extending treatments to give a dying person time to reach a significant milestone, like a family event or a personal achievement

48

I think life-extending treatments for people who are terminally ill are of less value as people get older

49

Treating people at the end of life is not going to result in big health gains but the health system should be about looking after those patients in greatest need