EUTHANASIA AND PHYSICIAN-ASSISTED SUICIDE - A COMPARATIVE SURVEY OF PHYSICIANS, TERMINALLY ILL CANCER-PATIENTS, AND THE GENERAL-POPULATION

Purpose and Methods: There is an ongoing debate about the legalization of euthanasia. The attitudes and beliefs of the general public and ph ysicians appear to differ; the views of patients have not been adequat ely explored. During 1995, we conducted a simultaneous survey in the p rovince of Alberta, Canada, of a random sample of 1,240 individuals fr om the general population, 179 physicians, and 62 consecutive patients with terminal cancer. The same instrument was administered to the pub lic and physicians through telephone interview, and to patients in a f ace-to-face interview. Statements related to the legalization of eutha nasia: 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 s upport of active end of life measures included the following: group su rveyed, strength of religious beliefs, religion (highest support by in dividuals with no religion), education (lower education associated wit h higher support), and the perception of burden on families, and physi cal and emotional suffering by cancer patients. Conclusion: In all gro ups, a marked polarization of attitudes was observed, with most indivi duals either strongly agreeing or strongly disagreeing with the statem ents in the survey. Although a slight majority of the public supported euthanasia, one third opposed it. Most physicians opposed these inter ventions 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, (C) 1997 by American Society of Clinical Oncology.