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Canadian Journal of Public Health

, Volume 98, Issue 3, pp 235–239 | Cite as

Confusion Between Euthanasia and Other End-of-Life Decisions

Influences on Public Opinion Poll Results
  • Isabelle Marcoux
  • Brian L. Mishara
  • Claire Durand
Article

Abstract

Background

Public opinion polls indicate that a majority of Canadians are in favour of euthanasia. However, there have been many criticisms of the validity of these findings. The objective of this study was to assess public opinion towards euthanasia while controlling for possible threats to validity indicated in the literature review.

Methods

A telephone public opinion poll was conducted in 2002 with a representative sample of the general population of Quebec (n=991; response rate=49.8%). Respondents were asked about their support for euthanasia and treatment withdrawal and, for comparison, were asked a previously used question on euthanasia (Gallup) which has been criticized for methodological problems. Respondents were also asked to distinguish between euthanasia and other end-of-life decisions in hypothetical scenarios.

Results

Eleven percent more people supported euthanasia with the Gallup question than the question developed in this study. Support for euthanasia (69.6%) was less prevalent than for treatment withdrawal (85.8%). Respondents who failed to distinguish between euthanasia and treatment withdrawal or withholding treatment in hypothetical scenarios were more likely to support euthanasia in public opinion poll questions. Furthermore, there is a significant relationship between opinions about the acceptability of euthanasia and inaccurate knowledge of the nature of euthanasia.

Interpretation

Public opinion polls on euthanasia must be interpreted in the light of the wording of the question. Education of the population concerning euthanasia and other end-of-life decisions may be considered to be an important prerequisite to engage in public debate concerning the legalization of euthanasia.

MeSH terms

Euthanasia public opinion withdrawing treatment knowledge problem formulation 

Résumé

Contexte

Les sondages d’opinion révèlent que la population canadienne est majoritairement favorable à l’euthanasie. Toutefois, certains auteurs critiquent la validité de ces résultats. Cette étude vise à examiner l’opinion publique sur la question de l’euthanasie en prenant en compte les problèmes méthodologiques identifiés dans les écrits scientifiques.

Méthode

En 2002, un sondage d’opinion a été réalisé auprès d’un échantillon représentatif de la population québécoise (n=991; taux de réponse=49,8 %). Les répondants ont été priés de donner leur opinion sur l’euthanasie et l’arrêt de traitement; pour fins de comparaison, on a également posé une question utilisée antérieurement par la firme Gallup et qui avait été critiquée pour des raisons de méthode. À partir de vignettes, les répondants devaient également distinguer l’euthanasie d’autres pratiques de fin de vie.

Résultats

L’appui à l’euthanasie était supérieur de 11 points de pourcentage avec la question Gallup qu’avec celle élaborée dans le cadre de notre étude. L’appui à l’euthanasie (69,6 %) était moins élevé que l’appui à l’arrêt de traitement (85,8 %). Les répondants qui n’ont pu distinguer l’euthanasie de l’abstention de traitement ou de l’arrêt de traitement à partir des vignettes étaient plus favorables à l’euthanasie. De plus, il y avait une relation significative entre l’appui à l’euthanasie et la méconnaissance de l’euthanasie, démontrée par le fait de ne pas avoir reconnu la vignette décrivant la situation d’euthanasie.

Interprétation

Les sondages d’opinion sur l’euthanasie doivent être interprétés en tenant compte de la manière dont les questions sont formulées. L’information de la population sur l’euthanasie et les autres pratiques de fin de vie devrait être considérée comme une condition préalable à un débat éclairé sur la légalisation de l’euthanasie.

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References

  1. 1.
    Special Senate Committee on Euthanasia and Assisted Suicide. Of Life and Death. Ottawa, ON: The Senate of Canada, 1995.Google Scholar
  2. 2.
    Gallup Canada. The Gallup Report. Toronto, ON: Canadian Institute of Public Opinion, 2002.Google Scholar
  3. 3.
    Roy Morgan Research Centre. Morgan Polls on Medically Assisted Death. Finding, No.2933. Melbourne, Australia: Roy Morgan Research Centre, 1996.Google Scholar
  4. 4.
    O’Neill CO, Feenan D, Hugues C, McAlister, DA. Attitudes to physician assisted suicide: Results from a study of public attitudes in Britain. J Med Ethics 2002;28:52.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    DeCesare, MA. Public attitudes toward euthanasia and suicide for terminally ill persons: 1977 and 1996. Soc Biol 2000;47:264–76.PubMedGoogle Scholar
  6. 6.
    van der Maas PJ, Pijnenborg L, van Delden, JM. Changes in Dutch opinions on active euthanasia, 1996 through 1991. JAMA 1995;273:1411–14.CrossRefPubMedGoogle Scholar
  7. 7.
    Materstvedt LJ, Kaasa S. Euthanasia and physician-assisted suicide in Scandinavia — with a conceptual suggestion regarding international research in relation to the phenomena. Palliat Med 2002;16:17–32.CrossRefPubMedGoogle Scholar
  8. 8.
    World Medical Association. The World Medical Association resolution on euthanasia (adopted by the WMA General Assembly, Washington 2002). Available online at: https://doi.org/www.wma.net/e/ policy/e13b.htm (Accessed June 13, 2006).Google Scholar
  9. 9.
    Canadian Medical Association. Euthanasia and assisted suicide (update 1998). Available online at: https://doi.org/www.cma.ca/index.cfm/ci_id/3214/ la_id/1.htm (Accessed June 13, 2006).Google Scholar
  10. 10.
    American Medical Association. E-2.21 Euthanasia. Available online at: https://doi.org/www.amaassn.org/ama/pub/category/8458.html (Accessed June 13, 2006).Google Scholar
  11. 11.
    British Medical Association. End of life decisions — views of the BMA. Available online at: https://doi.org/www.bma.org.uk/ap.nsf/AttachmentsBy Title/PDFEndoflifedecisions/$FILE/EndofLife Decisions.pdf (Accessed April 4, 2007).Google Scholar
  12. 12.
    Australian Medical Association. Care of severely and terminally ill patients. Available online at: https://doi.org/www.ama.com.au/web.nsf/doc/SHED-5FK3EP/$file/healths_gd_ps_care%20sev%20&%20term% 20ill%20pats.pdf (Accessed June 13, 2006).Google Scholar
  13. 13.
    van der Maas PJ, van Delden JJM, Pijnenborg L, Looman CWN. Euthanasia and other medical decisions concerning the end of life. Lancet 1991;338:669–74.CrossRefGoogle Scholar
  14. 14.
    Quill TE, Meier DE, Block SD, Billings, JA. The debate over physician-assisted suicide: Empirical data and convergent views. Ann Intern Med 1998;128:552–58.CrossRefPubMedGoogle Scholar
  15. 15.
    Silveira MJ, DiPiero A, Gerrity MS, Feudtner C. Patients’ knowledge of options at the end of life: Ignorance in the face of death. JAMA 2000;284:2483–88.CrossRefPubMedGoogle Scholar
  16. 16.
    van der Maas PJ, van der Wal G, Haverkate I, de Graaff CLM, Kester JGC, Onwuteaka-Philipsen BD, et al. Euthanasia, physician-assisted suicide, and other medical practices involving the end of life in the Netherlands, 1990–1995. N Engl J Med 1996;335:1699–705.CrossRefPubMedGoogle Scholar
  17. 17.
    Wolfe J, Fairclough DL, Clarridge BR, Daniels ER, Emanuel, EJ. Stability of attitudes regarding physician-assisted suicide and euthanasia among oncology patients, physicians, and the general public. J Clin Oncol 1999;17:1274–79.CrossRefPubMedGoogle Scholar
  18. 18.
    Emanuel EJ, Fairclough DL, Daniels ER, Clarridge, BR. Euthanasia and physician-assisted suicide: Attitudes and experiences of oncology patients, oncologists, and the public. Lancet 1996;347:1805–10.CrossRefPubMedGoogle Scholar
  19. 19.
    Hagelin J, Nilstun T, Hau J, Carlsson H-E. Surveys on attitudes towards legalisation of euthanasia: Importance of question phrasing. J Med Ethics 2004;30:521–23.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Somerville M. Death Talk: The Case Against Euthanasia and Physician-assisted Suicide. Montreal, QC: McGill-Queen’s University Press, 2001.Google Scholar
  21. 21.
    Gallagher R. Using a trade-show format to educate the public about death and survey public knowledge and needs about issues surrounding death and dying. J Pain Symptom Manage 2001;21:52–58.CrossRefPubMedGoogle Scholar
  22. 22.
    Stauch M. Causal authorship and the equality principle: A defence of the acts/omissions distinction in euthanasia. J Med Ethics 2000;26:237–41.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Begley A-M. Acts, omissions, intentions and motives: A philosophical examination of the moral distinction between killing and letting die. J Adv Nurs 1998;28:865–73.CrossRefPubMedGoogle Scholar
  24. 24.
    Garrard E, Wilkinson S. Passive euthanasia. J Med Ethics 2005;31:64–68.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Tabadoa P. Concepts and definitions: A source of confusion in the euthanasia debate. Palliat Med 2003;17:651–52.CrossRefGoogle Scholar
  26. 26.
    van der Wal G. From the Netherlands. Palliat Med 2003;17:110.CrossRefGoogle Scholar
  27. 27.
    Saunders C. From the, UK. Palliat Med 2003;17:102–3.CrossRefGoogle Scholar
  28. 28.
    Lavrakas, PJ. Telephone Survey Methods: Sampling, Selection, and Supervision. Newbury Park, CA: Sage, 1987.Google Scholar
  29. 29.
    Kimsma, GK. Euthanasia and euthanizing drugs in the Netherlands. In: Battin MP (Ed.), Drug Use in Assisted Suicide and Euthanasia. New York, NY: The Haworth Press Inc., 1996.Google Scholar
  30. 30.
    New Zealand Medical Association. Euthanasia and doctor-assisted suicide (July 2005). Available online at: https://doi.org/www.nzma.org.nz/news/ policies/euthanasia.html (Accessed April 4, 2007).Google Scholar
  31. 31.
    Roy DJ, Williams JR, Dickens BM, Baudouin J-L. La bioéthique: ses fondements et ses controverses. Saint-Laurent (Québec): Éditions du Renouveau pédagogique, 1995.Google Scholar
  32. 32.
    McInerney F, Seibold C. Nurses’ definitions of attitudes towards euthanasia. J Adv Nurs 1995;22:171–82.CrossRefPubMedGoogle Scholar
  33. 33.
    Kimsma GK, van Leeuwen E. Comparing two euthanasia protocols: The Free University of Amsterdam Academic Hospital and the Medical Center of Alkmaar. In: Thomasma DC, Kimbrough-Kushner T, Kimsma GK, Ciesielski-Carlucci C (Eds.), Asking to Die. Inside the Dutch Debate about Euthanasia. Dordrecht: Kluwer, 1998;115–33.Google Scholar

Copyright information

© The Canadian Public Health Association 2007

Authors and Affiliations

  • Isabelle Marcoux
    • 1
    • 2
  • Brian L. Mishara
    • 1
  • Claire Durand
    • 3
  1. 1.CRISE/UQAMMontrealCanada
  2. 2.Psychology DepartmentUniversity of Quebec at MontrealMontrealCanada
  3. 3.Department of SociologyUniversity of MontrealCanada

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