Opinion polls on assisted dying

A pan-European poll on assisted dying has been published recently, and in view of the recent non-governmental consultation Choice at the End of Life, reported here, it is pertinent to review its results for which the much of the media followed the line in the Daily Mail that “Majority of Brits want assisted suicide legalised as new poll reveals strong support for change in the law across Europe”.

The poll was commissioned by the Swiss Medical Lawyers Association (SMLA) and undertaken by ISOPUBLIC, the Swiss member of GALLUP INTERNATIONAL/WIN group. It took the form of on-line interviews of a sample of ~1,000 in each of 12 European countries, including the UK. The on-line panel of ISOPUBLIC conducted the interviews between 24 September and 9 October 2012 and the interviewees were asked the following questions,

  1. Firstly, in principle: Do you think that everyone should be able to decide for him/herself when and how he/she wishes to die, or should this not be left to the individual?
  2. Assuming that you suffer from an incurable serious illness, serious disability or uncontrollable pain: Can you imagine considering assisted suicide for yourself, or would this be out of the question for you?
  3. Assuming assisted suicide is legally permitted: Should assisted suicide be possible exclusively with professional assistance – i.e. with a doctor or a trained assisted suicide practitioner, or should assisted suicide also be able to be carried out without professional assistance?
  4. Do you think that it is right or not that a form of assisted suicide is banned in <named country>? [Question not asked in Germany]. 
  5. Do you agree with the statement that doctors who assist the intentional ending of the life of a seriously ill person should be struck off, or do you not agree?
  6. One final question on the subject: Do you think that if assisted suicide is legalised someone like you could be put under pressure to choose suicide as quickly as possible? Do you think that this … could happen?

Comment

We have no specific expertise in the interpretation or comparison of opinion polls, but suspect that this is no different from most writers of headlines in the media.  The report notes that

“[t]he study was executed in the correspondent language of each country”

and is written in relation to “assisted suicide”, a term which is not defined, but in view of the scope of Question 2 encompasses a wide range of circumstances.  This is of particular relevance in the United Kingdom since the draft Bill proposed by the All-Party Parliamentary Group (APPG) in partnership with Dignity in Dying relates to the narrower concept of assisted dying,

”to enable competent adults who are terminally ill to be provided at their request with specific assistance to end their own life, and for connected purposes”.

Whilst supporters of the Bill might argue that responses in favour of the broader context of ‘assisted suicide’ could be taken as assent to the more restricted ambit of the proposed Bill, others might feel, like Peter Saunders of the Christian Medical Comment blog that:

  • “support for legalisation is uninformed. Most people have little understanding of the complexities and dangers in legalising assisted suicide or euthanasia and are ignorant of what has happened when it has been legalised elsewhere. because support for legalisation is uninformed”, and
  • “support for assisted suicide, or any other form of euthanasia, is generally reflex rather than considered”.

The recent poll provides an interesting supplement to the YouGov/Telegraph and ComRes data reported in February 2010. However, for a direct comparison it would be necessary to assume that public attitudes have not changed in the intervening period, and any apparent differences are not as a consequence of the methodologies used, or the events preceding the poll. Nevertheless, both the ComRes and YouGov polls indicated similar levels of support for assisted suicide to the ISOPUBLIC poll, i.e. 71% to 75%.

The ComRes poll was the only one of the three that asked specifically about the medical condition of the sufferer – an issue that is the on-going concern of the English courts, here. It was found that 48% thought a friend or family member should be able to assist in such a suicide without prosecution, whereas 49% thought they should not; and for medical professionals 45% were supportive against 52% opposing.

The ISOPUBLIC study found that for the UK:

  • 82% felt that the individual should decide how he wishes to die; 14% did not (Q1);
  • 19% indicated that assisted suicide would be out of the question (Q2);
  • 12% thought that assisted suicide should be able to be carried out without professional assistance (Q3);
  • 17%  considered it wrong to ban (in law) assisted dying whereas 76% did not (Q4);
  • 84% thought that doctors who assist the intentional ending of the life of a seriously ill person should not be struck off but 9% did; and
  • only 7% thought that the possibility of being put under pressure to choose suicide as quickly as possible was relatively low – but this becomes significant (35%) if the results for “frequently” and “occasionally” are added together (Q6).

Comment

In writing this post and attempting to present a balanced picture, the problems faced by ISOPUBLIC soon became apparent.  Survey design in an area as sensitive as this is exceedingly difficult to ensure that the questions are as unbiassed as possible so as to avoid prompting the respondent – difficult in one language but much more so in a multi-lingual survey.  However, the poll designers appear to have achieved this in the phrasing of both the questions and the possible responses.

On the whole, the headline in the Mail is not an inaccurate representation of the general findings of the report, although the article itself provides more information on comparative attitudes between the 12 countries covered by the study. However, the situation in individual countries is more complex; and both supporters and opponents may find aspects which assist the promotion of their views. As we have noted in an earlier post, like the debate about same-sex marriage, the assisted suicide issue is not going to go away.

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