Factors associated with the rejection of active euthanasia: a survey among the general public in Austria

BMC Medical Ethics

Wolfgang Freidl¹  Franziska Grossschädl¹  Nathalie T Burkert¹  Willibald J Stronegger¹ 

[1]Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsstrasse 6/I, 8010, Graz, Austria

关键词: Austria;    Public opinion;    End-of-life care;    Attitude;    Euthanasia;   

Others  :  799934
DOI  :  10.1186/1472-6939-14-26

 received in 2012-11-19, accepted in 2013-07-01,  发布年份 2013

【 摘 要 】

Background

In recent decades, the general public has become increasingly receptive toward a legislation that allows active voluntary euthanasia (AVE). The purpose of this study was to survey the current attitude towards AVE within the Austrian population and to identify explanatory factors in the areas of socio-demographics, personal experiences with care, and ideological orientation. A further objective was to examine differences depending on the type of problem formulation (abstract vs. situational) for the purpose of measuring attitude.

Methods

A representative cross-sectional study was conducted across the Austrian population. Data were acquired from 1,000 individuals aged 16 years and over based on telephone interviews (CATI). For the purpose of measuring attitude toward AVE, two different problem formulations (abstract vs. situational) were juxtaposed.

Results

The abstract question about active voluntary euthanasia was answered negatively by 28.8%, while 71.2% opted in favour of AVE or were undecided. Regression analyses showed rejection of AVE was positively correlated with number of adults and children in the household, experience with care of seriously ill persons, a conservative worldview, and level of education. Mean or high family income was associated with lower levels of rejection. No independent correlations were found for variables such as sex, age, political orientation, self-rated health, and experiences with care of terminally ill patients. Correlation for the situational problem formulation was weaker and included fewer predictors than for the abstract question.

Conclusions

Our results suggest that factors relating to an individual’s interpersonal living situation and his/her cognitive convictions might be important determinants of the attitude toward AVE. If and to the extent that personal care experience plays a role, it is rather associated with rejection than with acceptance of AVE.

【 授权许可】

   
2013 Stronegger et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Pakes F: The legalisation of euthanasia and assisted suicide: a tale of two scenarios. IntJ Sociol of Law 2005, 33:71-84.
• [2]Van der Heide A, Onwuteaka-Philipsen BD, Rurup ML, Buiting HM, van Delden JJ, Hanssen-de Wolf JE, Janssen AG, Pasman HR, Rietjens JA, Prins CJ, Deerenberg IM, Gevers JK, van der Maas PJ, van der Wal G: End-of-life practices in the Netherlands under the Euthanasia Act. N Engl J Med 2007, 356(Pt 19):1957-1965.
• [3]Hinterhuber H, Meise U: Gedanken zu den Sterbehilfe-Bestrebungen in europäischen Ländern. [Euthanasia and medically assisted suicide – attempts in European countries]. Neuropsychiatr 2008, 22(Pt 4):277-282.
• [4]Smets T, Bilsen J, Cohen J, Rurup ML, Deliens L: Legal euthanasia in Belgium: characteristics of all reported euthanasia cases. Med Care 2010, 48(2):187-192.
• [5]Van der Maas PJ, Pijnenborg L, van Delden JJ: Changes in Dutch opinions on active euthanasia, 1966 through 1991. JAMA 1995, 273:1411-1114.
• [6]Schröder C, Schmutzer G, Klaiber A, Brähler E: Ärztliche Sterbehilfe im Spannungsfeld zwischen Zustimmung zur Freigabe und persönlicher Inanspruchnahme – Ergebnisse einer repräsentativen Befragung der deutschen Bevölkerung. [Attitudes towards professional euthanasia in the range between agreement in society and personal preferences–results of a representative survey of the German general population]. Psychother Psychosom Med Psychol 2003, 53:334-343.
• [7]Moulton BE, Hill TD, Burdette A: Religion and trends in euthanasia attitudes among US adults, 1977–2004. Sociological Forum 2006, 21(2):249-272.
• [8]Cohen J, Marcoux I, Bilsen J, Deboosere P, van der Wal G, Deliens L: European public acceptance of euthanasia: Socio-demographic and cultural factors associated with the acceptance of euthanasia in 33 European countries. Soc Sci Med 2006, 63:743-756.
• [9]Cohen J, Marcoux I, Bilsen J, Deboosere P, van der Wal G, Deliens L: Trends in acceptance of euthanasia among the general public in 12 European countries (1981–1999). Eur J Public Health 2006, 16:663-669.
• [10]Buiting HM, Deeg DJ, Knol DL, Ziegelmann JP, Pasman HR, Widdershoven GA, Onwuteaka-Philipsen BD: Older peoples' attitudes towards euthanasia and an end-of-life pill in The Netherlands: 2001–2009. J Med Ethics 2012, 38(5):267-273.
• [11]Peretti-Watel P, Bendiane MK, Pegliasco H, Lapiana JM, Favre R, Galinier A, Moatti JP: Doctors’ opinions on euthanasia, end-of-life care, and doctor-patient communication: telephone survey in France. BMJ 2003, 327:595-596.
• [12]Seale C: Legalisation of euthanasia or physician-assisted suicide: survey of doctors’ attitudes. Palliat Med 2009, 23:205-212.
• [13]McCormack R, Clifford M, Conroy M: Attitudes of UK doctors towards euthanasia and physician-assisted suicide: a systematic literature review. Palliat Med 2012, 26(1):23-33.
• [14]Ritter K, Etzersdorfer E, Stompe T: Die Nähe zum medizinischen Beruf und die Einstellung zur aktiven Sterbehilfe. [The closeness to the medical profession and the attitude towards euthanasia]. Neuropsychiatr 2009, 23(3):164-173.
• [15]Stronegger WJ, Schmölzer C, Rásky E, Freidl W: Changing attitudes towards euthanasia among medical students in Austria. J Med Ethics 2011, 37(4):227-229.
• [16]Kearl MC, Harris R: Individualism and the emerging “modern” ideology of death. Omega 1981, 12(3):269-280.
• [17]Monte P: Attitudes toward the voluntary taking of life: an updated analysis of euthanasia correlates. Sociological Spectrum 1991, 11:265-277.
• [18]Jaspers E, Lubbers M, Dirk de Graaf N: ‘Horrors of Holland’: explaining attitude change towards euthanasia and homosexuals in the Netherlands, 1970–1998. Int J Publ Opin Res 2007, 19:451-473.
• [19]Verbakel E, Jaspers E: A comparative study on permissiveness toward euthanasia: religiosity, slippery slope, autonomy, and death with dignity. Public Opin Q 2010, 74(1):109-139.
• [20]Blendon RJ, Szalay US, Knox RA: Should physicians aid their patients in dying? The public perspective. JAMA 1992, 267(19):2658-2662.
• [21]EVS: European Values Study 2008: Integrated Dataset (EVS 2008). Cologne: GESIS Data Archive ZA4800 Data file Version 3.0.0; 2011. http://www.europeanvaluesstudy.eu/ webcite
• [22]Hagelin J, Nilstun T, Hau J, Carlsson HE: Surveys on attitudes towards legalisation of euthanasia: importance of question phrasing. J Med Ethics 2004, 30(Pt 6):521-523.
• [23]Leinbach RM: Euthanasia attitudes of older persons – a cohort analysis. Res Aging 1993, 15(4):433-448.
• [24]Jorgenson DE, Neubecker RC: Euthanasia: a national survey of attitudes toward voluntary termination of life. Omega 1980, 11(4):281-291.
• [25]Rietjens JA, van der Heide A, Onwuteaka-Philipsen BD, van der Maas PJ, van der Wal G: A comparison of attitudes towards end-of-life decisions: survey among the Dutch general public and physicians. Soc Sci Med 2005, 61(8):1723-1732.
• [26]DeCesare MA: Public attitudes toward euthanasia and suicide for terminally ill persons: 1977 and 1996. Soc Biol 2000, 47(3–4):264-276.
• [27]Suarez-Almazor ME, Belzile M, Bruera E: Euthanasia and physician-assisted suicide: a comparative survey of physicians, terminally ill cancer patients, and the general population. J Clin Oncol 1997, 15(2):418-427.
• [28]Fischer S, Huber CA, Furter M, Imhof L, Mahrer Imhof R, Schwarzenegger C, Ziegler SJ, Bosshard G: Reasons why people in Switzerland seek assisted suicide: the view of patients and physicians. Swiss Med Wkly 2009, 139(23–24):333-338.
• [29]Karlsson M, Milberg A, Strang P: Dying cancer patients’ own opinions on euthanasia: An expression of autonomy? A qualitative study. Palliat Med 2012, 26:34-42.