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Public acceptance of euthanasia in Europe: a survey study in 47 countries

International Journal of Public Health volume 59, pages 143–156 (2014)Cite this article

Abstract

Objectives

In recent years, the European euthanasia debate has become more intense, and the practice was legalized in the Netherlands, Belgium, and Luxembourg. We aimed to determine the current degree of public acceptance of euthanasia across Europe and investigate what factors explain differences.

Methods

Data were derived from the 2008 wave of the European Values Survey (EVS), conducted in 47 European countries (N = 67,786, response rate = 69 %). Acceptance of euthanasia was rated on a 1–10 scale.

Results

Relatively high acceptance was found in a small cluster of Western European countries, including the three countries that have legalized euthanasia and Denmark, France, Sweden and Spain. In a large part of Europe public acceptance was relatively low to moderate. Comparison with the results of the previous EVS wave (1999) suggests a tendency towards a polarization in Europe, with most of Western Europe becoming more permissive and most of Eastern Europe becoming less permissive.

Conclusions

There is roughly a West-East division in euthanasia acceptance among the European public, making a pan-European policy approach to the issue difficult.

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References

  • Bachman JG, Alcser KH, Doukas DJ et al (1996) Attitudes of Michigan physicians and the public toward legalizing physician-assisted suicide and voluntary euthanasia. N Engl J Med 334(5):303–309

    Article  CAS  PubMed  Google Scholar 

  • Bulow HH, Sprung CL, Reinhart K et al (2008) The worldʼs major religionsʼ points of view on end-of-life decisions in the intensive care unit. Intensive Care Med 34(3):423–430

    Article  PubMed  Google Scholar 

  • Campbell CS (2000) Euthanasia and religion. UNESCO Courier 53(1):37–39

    Google Scholar 

  • Carlson P (1998) Self-perceived health in East and West Europe: another European health divide. Soc Sci Med 46(10):1355–1366

    Article  CAS  PubMed  Google Scholar 

  • Carlson P (2004) The European health divide: a matter of financial or social capital? Soc Sci Med 59(9):1985–1992

    Article  PubMed  Google Scholar 

  • Cohen J, Marcoux I, Bilsen J et al (2006a) European public acceptance of euthanasia: socio-demographic and cultural factors associated with the acceptance of euthanasia in 33 European countries. Soc Sci Med 63(3):743–756

    Article  PubMed  Google Scholar 

  • Cohen J, Marcoux I, Bilsen J et al (2006b) Trends in acceptance of euthanasia among the general public in 12 European countries (1981–1999). Eur J Public Health 16:663–669

    Article  PubMed  Google Scholar 

  • Cohen J, van Delden J, Mortier F et al (2008) Influence of physiciansʼ life stances on attitudes to end-of-life decisions and actual end-of-life decision-making in six countries. J Med Ethics 34(4):247–253

    Article  CAS  PubMed  Google Scholar 

  • Crumley B (2008) French Euthanasia case rumbles on. http://www.time.com/time/world/article/0,8599,1726787,00.html

  • De Moor R (1995) Values in Western Societies. Tilburg University Press, Tilburg

  • deCesare MA (2000) Public attitudes toward euthanasia and suicide for terminally ill persons: 1977 and 1996. Soc Biol 47(3–4):264–276

    Google Scholar 

  • Donovan GK (1997) Decisions at the end of life: Catholic tradition. Christ Bioethics 3(3):188–203

    Article  Google Scholar 

  • EVS (2010a) European values study 2008, 4th wave, Integrated Dataset. GESIS Data Archive, Cologne, Germany, ZA4800 Dataset Version 2.0.0 (2010-11-30). doi:10.4232/1.10188

  • EVS (2010b) EVS 2008 guidelines and recommendations. GESIS-Technical Reports 2010/16. http://www.europeanvaluesstudy.eu/

  • EVS, GESIS (2010): EVS 2008 Method Report. GESIS-Technical Reports 2010/17. http://www.europeanvaluesstudy.eu/

  • Ferreira N (2007) Latest legal and social developments in the euthanasia debate: bad moral consciences and political unrest. Med Law 26(2):387–407

    CAS  PubMed  Google Scholar 

  • Green-Pedersen C (2007) The conflict of conflicts in comparative perspective: Euthanasia as a political issue in Denmark, Belgium, and the Netherlands. Compar Politics 39(3):273–291

    Google Scholar 

  • Halman L, Luijkx R, van Zudert M (2005) Atlas of European values. Brill, Leiden

    Google Scholar 

  • Hevesi D (2008) Hugo Claus, one of Belgiumʼs most renowned authors, Dies at 78, New York Times

  • Holloway HD, Hayslip B, Murdock ME (1994) Measuring attitudes toward euthanasia. Omega (Westport) 30(1):53–65

    Google Scholar 

  • Jorgenson DE, Neubecker RC (1980) Euthanasia: a national survey of attitudes toward voluntary termination of life. Omega (Westport) 11(4):281–291

    Google Scholar 

  • Kelner MJ, Bourgeault IL (1993) Patient control over dying: responses of health care professionals. Soc Sci Med 36(6):757–765

    Article  CAS  PubMed  Google Scholar 

  • Kopfensteiner TR (1996) Death with dignity: a Roman Catholic perspective. Linacre Q 63(4):64–75

    PubMed  Google Scholar 

  • Laaksonen M, McAlister AL, Laatikainen T et al (2001) Do health behaviour and psychosocial risk factors explain the European east–west gap in health status? Eur J Public Health 11(1):65–73

    Article  CAS  PubMed  Google Scholar 

  • Larue GA (1985) Euthanasia and religion. A survey of the attitudes of world religions to the right-to-die. The Hemlock Society, Los Angeles

    Google Scholar 

  • Leinbach RM (1993) Euthanasia attitudes of older persons: a cohort analysis. Res Aging 15(4):433–448

    Article  Google Scholar 

  • Oehmichen M, Meissner C (2003) Active euthanasia and physician-assisted suicide: the German discussion. Legal Medicine (Tokyo) 5(Suppl 1):S20–S28

    Article  Google Scholar 

  • Rietjens JA, van der Heide A, Onwuteaka-Philipsen BD et al (2005) A comparison of attitudes towards end-of-life decisions: survey among the Dutch general public and physicians. Soc Sci Med 61(8):1723–1732

    Article  PubMed  Google Scholar 

  • Schroder C, Schmutzer G, Klaiberg A et al (2003) Attitudes towards professional euthanasia in the range between grement in the society and personal preferences—results of a representative examination of the German general population. Psychother Psychosom Med Psychol 53(8):334–343

    Article  PubMed  Google Scholar 

  • Schroepfer TA, Noh H, Kavanaugh M (2009) The myriad strategies for seeking control in the dying process. Gerontologist 49(6):755–766

    Article  PubMed  Google Scholar 

  • Seale C (2000) Changing patterns of death and dying. Soc Sci Med 51(6):917–930

    Article  CAS  PubMed  Google Scholar 

  • Sikora J (2009) Religion and attitudes concerning euthanasia Australia in the 1990s. J Sociol 45(1):31–54

    Article  Google Scholar 

  • Snelling PC (2004) Consequences count: against absolutism at the end of life. J Adv Nurs 46(4):350–357

    Article  PubMed  Google Scholar 

  • Suarez-Almazor ME, Belzile M, Bruera E (1997) Euthanasia and physician-assisted suicide: a comparative survey of physicians, terminally ill cancer patients, and the general population. J Clin Oncol 15(2):418–427

    CAS  PubMed  Google Scholar 

  • Tomka M (2002) Religious restoration in Eastern Europe—introduction. Social Compass 49(4):483–495

    Article  Google Scholar 

  • Tomka M (2004) Religious changes in central and eastern Europe. Revue D Etudes Comparatives Est-Ouest 35(4):11–35

    Article  Google Scholar 

Download references

Acknowledgments

Joachim Cohen is a postdoctoral Fellow of the Research Foundation - Flanders (FWO). This study used data of the European Values Study 2008, 4th wave, Integrated Dataset. GESIS Data Archive, Cologne, Germany, ZA4800 Dataset Version 2.0.0 (2010-11-30), doi:10.4232/1.10188. The analyses and writing activities were funded by a grant from the Research Council of the Vrije Universiteit Brussel (HOA27). We would like to thank Jane Ruthven for proofreading and copy editing the manuscript.

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Authors and Affiliations

  1. End-of-Life Care Research Group, Ghent University, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium

    Joachim Cohen, Paul Van Landeghem & Luc Deliens

  2. Vrije Universiteit Brussel, Brussels, Belgium

    Joachim Cohen & Paul Van Landeghem

  3. SCOM, Vrije Universiteit Brussel, Pleinlaan 2, 1040, Brussels, Belgium

    Nico Carpentier

  4. Department of Social Sciences, University of Loughborough, Loughborough, UK

    Nico Carpentier

  5. Department of Public and Occupational Health, EMGO Institute, VU University Medical Centre, Amsterdam, The Netherlands

    Luc Deliens

Authors
  1. Joachim Cohen
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  2. Paul Van Landeghem
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  3. Nico Carpentier
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  4. Luc Deliens
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Corresponding author

Correspondence to Joachim Cohen.

Additional information

J. Cohen and P. Van Landeghem contributed equally to this work.

Appendix

Appendix

See Tables 2, 3 and 4.

Table 2 Constructed measures through principal component analysis (items and component loadings)
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Tables 3 Results of the ANCOVA analysis
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Tables 4 Results of linear mixed-effects model analysis
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Cohen, J., Van Landeghem, P., Carpentier, N. et al. Public acceptance of euthanasia in Europe: a survey study in 47 countries. Int J Public Health 59, 143–156 (2014). https://doi.org/10.1007/s00038-013-0461-6

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  • DOI: https://doi.org/10.1007/s00038-013-0461-6

Keywords

  • Euthanasia
  • Public opinion
  • Cross-national comparison
  • Survey
  • Eastern Europe
  • Western Europe