Public support for euthanasia in countries like the United States is quite strong according existing polling data. But support appears to wane when respondents are given more detailed information about the complexities of medically-assisted suicide.
A new paper in The American Journal of Geriatric Pyschiatry looks specifically at public attitudes to euthanasia for patients with dementia, and considers how respondents’ attitudes change when they are presented with case studies of individuals with severe dementia who have made an advanced request for euthanasia.
Researchers from the National Institutes of Health administered an online survey to over 1700 US-based participants, matched to US population in age, sex, race and/or ethnicity, education, household income, and political affiliation.
The survey began with a description of advanced dementia and then asked participants an initial policy question about their attitudes to the legalisation of advanced request euthanasia/assisted suicide (AR-EAS). Respondents were then asked to read a scenario involving a decisionally incapacitated patient with dementia with an advance request for EAS to be implemented when “...she is completely dependent on others and can no longer recognize her family”. After reading the scenario, respondents were then asked whether their attitudes towards the legalisation of AR-EAS had changed.
Initial support for AR-EAS among respondents was 54%, with almost a quarter of respondents (22.6%) saying that they were unsure. Factors associated with higher initial support toward AR-EAS legalization included younger age, being more liberal and nonreligious, and having a more negative perception of quality of life with dementia.
However, the researchers found an overall decrease in support for legalization after participants read the scenarios. Indeed, in response to a follow-up policy question, only a minority agreed with legalization, ranging from 37% to 49% depending on the scenario they had been presented with.
The study authors draw a methodological conclusion from their findings about how researchers should survey public attitudes to euthanasia. They state that “simply asking whether AR-EAS should be legal following a description of life with dementia may fail to capture the public’s considered views”. Rather, it is important that respondents are given insight into the complexities of illnesses like dementia. The authors note that there is a “tragedy discourse” surrounding advanced illness in later life, and that this biased picture of progressive illness can cloud people’s views on an issue like euthanasia.
Xavier Symons is deputy editor of BioEdge