Attitudes concerning Euthanasia: Australia at the Turn of the 21st Century
Sikora, Joanna, Lewins, Frank, Health Sociology Review
With rapid developments in life-prolonging technologies and increases in average life expectancy, euthanasia has become an increasingly topical issue. This paper contributes to the euthanasia debate an analysis of Australian attitudes to assisted suicide, active non-voluntary as well as passive non-voluntary euthanasia. Between 1993 and 2002, Australians supported access to voluntary euthanasia of the terminally ill, but had reservations when death was not imminent. The age of patients was relatively unimportant in these considerations. Non-voluntary euthanasia of babies and adults received widespread approval only when particular situations could be defined as 'letting die' rather than 'killing'.
Sociology, attitudes to euthanasia Australia, public opinion - Australia, survey studies of attitudes, assisted suicide, mercy killing
Received 4 November 2005 Accepted 6 November 2006
The recent bitter and anguished debate over the fate of Terry Schiavo, the US woman who spent years in a coma, is but one example of the consternation surrounding the issue of euthanasia. Such debates raise the question of whether death should be a choice and, if so, for whom and under what circumstances? Even before the Schiavo debate, life prolonging technologies, substantial increases in average life expectancy and activists' efforts have gradually made more transparent, public, and legitimate, a practice which had previously been less visible (Riley 1983:192-193). Some recent examples include Lesley Martin's admission of the 'mercy killing' of her terminally ill mother in New Zealand, the suicide of Australia's Nancy Crick (committed in the belief she had cancer, see Daily Telegraph 2004; Paget 2004) and the pro-choice campaign of the Australian euthanasia activist, Dr Phillip Nitschke, who publicises the 'Peaceful Pill' (King 2004).
Euthanasia: Conceptual complexities
The complex nature of situations in which acts of euthanasia occur necessitates an analytical approach involving varying degrees of human agency and intent. Therefore, we compare and contrast moral evaluations of active, passive as well as voluntary and non-voluntary euthanasia, which reflect the different levels of a patient's agency or autonomy (Lewins 1996:113-114).
In common discourse, the distinction between active and passive euthanasia is often reduced to a difference between 'killing' and 'letting die'. Voluntary euthanasia is a consensual act of an individual, in full awareness of the nature and likely consequences of their action. Although voluntary euthanasia is not always considered synonymous with assisted suicide (Dworkin et al. 1998), we treat these two concepts as equivalent for the purpose of this analysis, due to the nature of our data. Involuntary euthanasia refers to situations when life is ended against the person's will which are outside the scope of this article. However, we describe attitudes concerning nonvoluntary euthanasia, which may be considered in cases involving newborn babies with serious medical conditions, individuals experiencing severe dementia or senility, and unconscious patients. It is this type of situation, where it is debatable whether the wishes of the person are known or knowable, that is most likely to present significant ethical problems.
Differences in perceived proscriptions from acts of euthanasia and the tension between supporters and opponents of the decriminalisation of voluntary euthanasia have spawned an extensive literature in moral philosophy, law, bioethics and sociology. Most of this literature belongs in applied ethics; only a small part addresses public opinion, which calls for an explanation of the purpose and value of attitudinal studies in this area.
Policy and public opinion concerning euthanasia
Studies stemming from democratic theory consistently find that public opinion is salient in policy development in Western industrialised countries (Brooks and Manza 2006; Burstein 1998, 2003, 2006). …