Euthanasia and physician-assisted suicide: a comparative survey of physicians, terminally ill cancer patients, and the general population

Abstract

Purpose and methods: There is an ongoing debate about the legalization of euthanasia. The attitudes and beliefs of the general public and physicians appear to differ; the views of patients have not been adequately explored. During 1995, we conducted a simultaneous survey in the province of Alberta, Canada, of a random sample of 1,240 individuals from the general population, 179 physicians, and 62 consecutive patients with terminal cancer. The same instrument was administered to the public and physicians through telephone interview, and to patients in a face-to-face interview. Statements related to the legalization of euthanasia and physician-assisted suicide were scored using 1-to-7 Likert agreement scales.

Results: A slight majority of members of the public and terminally ill patients (50% to 60%) agreed with the legalization of euthanasia and assisted suicide, while most physicians (60% to 80%) opposed it. In multivariate analysis, independent associations with support of active end of life measures included the following: group surveyed, strength of religious beliefs, religion (highest support by individuals with no religion), education (lower education associated with higher support), and the perception of burden on families, and physical and emotional suffering by cancer patients.

Conclusion: In all groups, a marked polarization of attitudes was observed, with most individuals either strongly agreeing or strongly disagreeing with the statements in the survey. Although a slight majority of the public supported euthanasia, one third opposed it. Most physicians opposed these interventions and appeared not to be willing to perform these procedures if legalized. Our findings suggest that legalization at this time could be highly divisive and controversial from a societal perspective.