Prosecutors and end-of-life decision making

Objective: To examine personal beliefs and professional behavior of state c riminal prosecutors toward end-of-life decisions. Design: Mail survey. Setting: District attorney offices nationwide. Participants: All prosecuting attorneys who are members of the National Dis trict Attorneys Association. A total of 2844 surveys were mailed with 2 fol low-up mailings at 6-week intervals; 761 surveys were returned for a respon se rate of 26.8%. The majority of respondents were white men, Protestant, a nd served in rural areas. Interventions: None. Main Outcome Measures: On the basis of 4 case scenarios, (1) professional b ehavior as determined by respondents' willingness to prosecute and what cri minal charges they would seek; and (2) personal beliefs as determined by wh ether prosecutors believed the physicians' actions were morally wrong and w hether they would want the same action taken if they were in the patient's condition. Results: Most respondents would not seek prosecution in 3 of the 4 cases. I n the fourth case, involving physician-assisted suicide, only about one thi rd of the respondents said that they definitely would prosecute. Those who would prosecute would most often seek a charge of criminal homicide. A majo rity of respondents believed that the physicians' actions were morally corr ect in each of the 4 cases and would want the same action taken if they wer e in the patient's position. There was a strong correlation between persona l beliefs and professional behaviors. Conclusions: A large majority of responding prosecutors were unwilling to p rosecute physicians in cases that clearly fall within currently accepted le gal and professional boundaries. In the case of physician-assisted suicide, results reflected a surprisingly large professional unwillingness to prose cute and an even greater personal acceptance of physician-assisted suicide.