When Is a Request for Assisted Suicide Legitimate? Factors Influencing Public Attitudes toward Euthanasia

By Achille, Marie A.; Ogloff, James R. | Canadian Journal of Behavioural Science, January 1997 | Go to article overview

When Is a Request for Assisted Suicide Legitimate? Factors Influencing Public Attitudes toward Euthanasia


Achille, Marie A., Ogloff, James R., Canadian Journal of Behavioural Science


When Is A Request for Assisted Suicide Legitimate? Factors Influencing Public Attitudes Toward Euthanasia

Abstract

A mail survey of 810 Greater Vancouver Area residents investigated how the public's acceptance of a request for euthanasia was influenced by the method of death (e.g., lethal injection vs. withdrawal of life - support) and by the identity of the patient featured in a vignette (e.g., stranger vs. oneself). The study also identified considerations people found most important in deciding whether a patient's request for euthanasia was legitimate (e.g., patient's pain, chance for recovery). Life - support withdrawal was found significantly more acceptable (90% support) than a lethal injection (79% support), yet the identity of the person involved did not affect the acceptability of euthanasia. However, a factor analysis suggested that the decisions about oneself may be more complex and more closely scrutinized than decisions about others. The considerations rated most important by participants paralleled legal guidelines from the Netherlands and Oregon.

Euthanasia certainly is not a recent concept, but the paradoxical stand of modern medicine, torn between an ever increasing capacity to prolong life and an inability to cure a number of debilitating diseases, has given the ending of life an entirely new meaning. In recent years, a number of highly publicized euthanasia cases have occurred in Canada (N.B. v Hotel - Dieu de Quebec, 1992; Rodriguez v. British Columbia, 1993; R. v. Latimer, 1995), stirring public controversy and heating up a sensitive debate between proponents and opponents of the right to die. This debate revolves around key arguments such as the difference between withdrawing treatment and actively inducing death, patients' rights to autonomy and privacy, the quality of life of the terminally ill, and the risk of misuse and abuse for the diseased, the elderly, and the handicapped (Chipeur & Maxwell, 1994; Hollander, 1989; Pellegrino, 1989; Rodriguez v. British Columbia, 1993; Yarnell & Battin, 1988).

ACTIVE VERSUS PASSIVE EUTHANASIA

A great source of controversy in the right to die debate pertains to the distinction between active and passive euthanasia. Active euthanasia involves "a deliberate act undertaken by one person with the intention of ending the life of another person to relieve that person's suffering" (Senate of Canada, 1995, p.14) (e.g., lethal injection), whereas passive euthanasia is "not starting ... or stopping treatment that has the potential to sustain the life of a patient" (Senate of Canada, 1995, p.14). Assisted - suicide, which involves providing someone with the means, advice, or any other form of help in committing suicide, fits into the active category.

Opinions among the general public and health - care professionals generally suggest that "inducing the death" of a patient is perceived to be worse than "doing nothing" to prevent a patient from dying (Bosmann, Kay, & Conter, 1987; Rachels, 1975; Sugarman, 1986; Winkler, 1985). The American, British, Canadian and World Medical Associations' official position is that the deliberate ending of life is unethical, regardless of the patient's request. These associations, however, grant that it is permissible to honour a terminally ill patient's request to let the disease follow its course (see Rodriguez v. British Columbia, 1993; Williams, 1991). In many jurisdictions, health - care providers who withdraw life - sustaining devices and issue "do not resuscitate" orders are no longer condemned by either civil or criminal courts, whereas those who participate in assisted suicide could face criminal and civil liability (Latimer, 1991; Lynn, 1988; Rachels, 1975; Wanzer, Federman, Adelstein, Cassel, Cassem, Cranford et al. 1989).

Many argue, however, that the distinction between active and passive euthanasia is morally irrelevant if the intrinsic goal of both is to eliminate human suffering (Lynn, 1988; O'Rourke, 1991; Rachels, 1975; Winkler, 1985). …

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