Factors Affecting Euthanasia

In the September 4 issue of the British. medical journal The Lancet, Canadian researchers report on how dying patients’ “will to live” is likely to show “substantial fluctuation” due to changes in both physical and mental factors. Dr. Harvey Chochinov of the University of Manitoba and his colleagues assessed the “will to live” twice daily in 168 mentally competent cancer patients admitted to palliative care, and correlated this with a variety of other factors. The patients ranged in age from 31 to 89 years old; they survived an average of 18 days, though one woman lived more than 150 days. The factors with the most impact on the will to live were “depression, anxiety, shortness of breath, and sense of well-being.” Which factor was most important varied with the stage of illness. During the earlier course of a patient’s illness, anxiety was the dominant factor; depression became more important later, and shortness of breath was the chief factor suppressing a will to live when death became imminent. The study confirmed that, at least during much of a terminal illness’s course, psychological factors weigh more heavily in a desire for death than factors such as physical pain.

Numerous US studies have established that the Americans most directly affected by the issue of physician-assisted suicide — those who are frail, elderly and suffering from terminal illness — are also more opposed to legalizing the practice than others are:

* A poll conducted for the Washington Post on March 22-26, 1996, found 50% support for legalizing physician-assisted suicide (Washington A18) Voters aged 35-44 supported legalization, 57% to 33%. But these figures reversed for voters aged 65 and older, who opposed legalization 54% to 38%. Majority opposition was also found among those with incomes under $15,000 (54%), and black Americans (70%).

* An August 1993 Roper poll funded by the Hemlock Society and other euthanasia supporters indicated that voters aged 18-29 supported “physician-aided suicide” 47% to 35%; voters aged 60 and older opposed it 45% to 35%. Hemlock’s newsletter commented that “the younger the person, the more likely he or she is to favor this legislation.” The newsletter added that “this is somewhat at odds with how Hemlock views its membership,” since it sees itself as defending the interests of elderly citizens. (Humphry; Poll 9) A study of cancer patients found that terminally ill patients experiencing significant pain are more opposed to physician-assisted suicide than other terminally ill patients or the general public.