Attitudes of Michigan Physicians and the Public toward Legalizing Physician-Assisted Suicide and Voluntary Euthanasia
Jerald G. Bachman, Ph.D., Kirsten H. Alcser, Ph.D., David J. Doukas, M.D., Richard L. Lichtenstein, Ph.D., Amy D. Corning, M.A., and Howard Brody, M.D., Ph.D.
Background There has been a continuing public debate about assistedsuicide and the proper role, if any, of physicians in this practice.Legislative bans and various forms of legalization have beenproposed.
Methods We mailed questionnaires to three stratified randomsamples of Michigan physicians in specialties likely to involvethe care of terminally ill patients: 500 in the spring of 1994,500 in the summer of 1994, and 600 in the spring of 1995. Similarquestionnaires were mailed to stratified random samples of Michiganadults: 449 in the spring of 1994 and 899 in the summer of 1994.Several different questionnaire forms were used, all of whichincluded questions about whether physician-assisted suicideshould be banned in Michigan or legalized under certain conditions.
Results Usable questionnaires were returned by 1119 of 1518physicians eligible for the study (74 percent), and 998 of 1307eligible adults in the sample of the general public (76 percent).Asked to choose between legalization of physician-assisted suicideand an explicit ban, 56 percent of physicians and 66 percentof the public supported legalization, 37 percent of physiciansand 26 percent of the public preferred a ban, and 8 percentof each group were uncertain. When the physicians were givena wider range of choices, 40 percent preferred legalization,37 percent preferred "no law" (i.e., no government regulation),17 percent favored prohibition, and 5 percent were uncertain.If physician-assisted suicide were legal, 35 percent of physicianssaid they might participate if requested 22 percentwould participate in either assisted suicide or voluntary euthanasia,and 13 percent would participate only in assisted suicide. Supportfor physician-assisted suicide was lowest among the stronglyreligious.
Conclusions Most Michigan physicians prefer either the legalizationof physician-assisted suicide or no law at all; fewer than onefifth prefer a complete ban on the practice. Given a choicebetween legalization and a ban, two thirds of the Michigan publicprefer legalization and one quarter prefer a ban.
Source Information
From the Survey Research Center, Institute for Social Research (J.G.B., K.H.A., D.J.D., R.L.L., A.D.C.), the Department of Family Practice, the Medical School (D.J.D.), and the School of Public Health (R.L.L.), University of Michigan, Ann Arbor; and the Center for Ethics and Humanities in the Life Sciences and the Departments of Family Practice and Philosophy, Michigan State University, East Lansing (H.B.).
Address reprint requests to Dr. Bachman at the Institute for Social Research, University of Michigan, Ann Arbor, MI 48106-1248.
Physician-Assisted Suicide
Kavanaugh A., Wilson K. G., Chochinov H. M., Toffler W. L., Edwards M. J., Hamilton N. G., Edwards P. J., Robinson S. T., Bachman J. G., Alcser K. H., Doukas D. J., Lichtenstein R. L., Lee M. A., Nelson H. D., Tilden V. P.
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N Engl J Med 1996;
335:518-520, Aug 15, 1996.
Correspondence
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[Full Text]
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[Full Text]
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159: 1521-1525
[Full Text]
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[Abstract][Full Text]
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159: 545-550
[Full Text]
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(1999). Patients with Amyotrophic Lateral Sclerosis and Physician-Assisted Suicide. NEJM
340: 817-817
[Full Text]
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[Full Text]
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[Abstract]
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[Abstract][Full Text]
Haghbin, Z., Streltzer, J., Danko, G. P.
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[Abstract][Full Text]
Muskin, P. R.
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[Abstract][Full Text]
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337: 1768-1771
[Full Text]
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Angell, M.
(1997). The Supreme Court and Physician-Assisted Suicide -- The Ultimate Right. NEJM
336: 50-53
[Full Text]
Linville, J. E.
(1996). Physician-Assisted Suicide as a Constitutional Right. J Law Med Ethics
24: 198-206
Miller, F. G., Brody, H., Quill, T. E.
(1996). Can Physician-Assisted Suicide Be Regulated Effectively?. J Law Med Ethics
24: 225-232
Orentlicher, D.
(1996). The Legalization of Physician-Assisted Suicide. NEJM
335: 663-667
[Full Text]
Kavanaugh, A., Wilson, K. G., Chochinov, H. M., Toffler, W. L., Edwards, M. J., Hamilton, N. G., Edwards, P. J., Robinson, S. T., Bachman, J. G., Alcser, K. H., Doukas, D. J., Lichtenstein, R. L., Lee, M. A., Nelson, H. D., Tilden, V. P.
(1996). Physician-Assisted Suicide. NEJM
335: 518-520
[Full Text]