Most Believe in Patients Right to Die but Few Have
Living Wills, Pew Research Finds
84% approve of laws saying medical treatment that is
keeping a terminally ill patient alive can be stopped if that is what
the patient desires
By Kim
Parker, Pew Research Center
Aug.
27, 2009 - The national debate over health care reform has focused new
attention on the decisions people make about medical care at the end
stages of life. Public opinion polls show that Americans overwhelmingly
support an individual's right to decide whether he or she wants to be
kept alive through medical treatment.
In a
2005 Pew Research Center survey, 84% said they approved of laws
which say medical treatment that is keeping a terminally ill patient
alive can be stopped if that is what the patient desires. In addition,
70% said there are some circumstances when a patient should be allowed
to die, while 22% said doctors and nurses should always do everything
possible to save the life of a patient.
While a heavy majority of Americans support
individual rights in this area, when it comes to personal preferences
about medical intervention for oneself at the end of life, the public is
more evenly divided.
In the same Pew Research survey a narrow majority
(53%) said if they were faced with a terminal illness and were suffering
a great deal of physical pain they would choose to stop medical
treatment, 34% said they would ask their doctor to do everything
possible to save their life.
It's not entirely clear what role the public thinks
government should play in these complicated matters. After Congress
intervened in 2005 in the case of Terri Schiavo, a brain-damaged Florida
woman who eventually died when her feeding tube was removed, there was a
significant public backlash.
More
than seven-in-ten Americans (72%) said Congress should have stayed out
of the case, only 17% believed Congress had done the right thing.
In spite of the partisan political debate caused by
the Schiavo case, Republicans and Democrats have similar views on the
broader issue of whether individuals have the right to make their own
decisions about end-of-life medical care.
Equally strong majorities of Republicans, Democrats
and independents approve of laws that let patients decide about being
kept alive through medical treatment. Similarly, views about whether
under certain circumstances a patient should be allowed to die do not
differ by party.
Race and religious affiliation are much more
strongly linked to attitudes about the right to die. Among whites, 75%
say that there are some circumstances where a patient should be allowed
to die. Only 40% of blacks agree. Catholics and white evangelical
Protestants are less likely than non-evangelical Protestants and
seculars to say patients should sometimes be allowed to die.
Making Plans for the End-of-Life
One
way to insure that an individual's desires about end-of-life medical
care are carried out is to put them in writing. Nearly all Americans
know what a "living will" is, and most have given at least some thought
to their own wishes regarding medical treatment at the end of their
life. In the 2005 Pew Research survey, 35% said they've given this a
great deal of thought and 36% said they've given it some thought. Even
so, only 27% said they have put their wishes in writing and 29% said
they have a living will. Though, this represented a significant increase
from 1990 when even fewer -- 12% -- had some sort of living will. Not
surprisingly, older people are more likely than young people to have
thought about these issues and to have formalized their wishes. Half of
those ages 65 and older (51%) say their wishes for medical treatment are
written down and 54% say they have a living will.
Most Americans believe that family members should
have a role in end-of-life decision making. A strong majority of the
public believes that when a terminally ill patient is unable to
communicate his or her wishes about medical care, the responsibility
rests with a family member. In the 2005 Pew Research Center survey, 74%
of respondents said in this situation, the closest family member should
be allowed to decide whether to continue medical treatment.
Do family members who find themselves in this
situation know what the wishes of their terminally ill loved ones are?
A recent survey by the Pew Research Center's Social
& Demographic Trends project found that among those ages 65 and older
with at least one living child,
63% have talked to their children about how to handle their medical care
if they can no longer make their own decisions; 35% have not discussed
this with their children. Older adults are more likely to have discussed
their will and what to do with family belongings than they are to have
discussed end-of-life medical decisions (76% have discussed their will
with their children).
According to elderly parents, they are most often
the ones who initiate these types of conversations. Among those who say
they have discussed these topics with their children, 70% say they
raised the issues while only 10% say their children initiated the
conversations.
Older women are much more likely than older men to
have discussed medical decision making with their children (71% vs.
52%). And older whites (66%) are more likely to have discussed this
issue with their children than are older blacks (56%) or Hispanics
(41%).
In addition to asking older Americans whether they
had discussed these issues with their children, the Pew Social &
Demographic Trends survey cited above questioned adult children about
their communications with their aging parents.
Among those adults with at least one living parent
age 65 or older, 57% said they have talked with their parents about how
to handle their parents' medical care if they can no longer make their
own decisions; 42% say they have not discussed this with their parents.
Like their parents, adult children are more likely to say they have
discussed their parents' wills and what to do with family belongings
than how to handle their parents' future medical care.
Daughters are more likely than sons to have had
these conversations with their parents: 65% of women vs. 48% of men say
they have talked to their parents about how to handle their medical care
if they become incapacitated. And white adults with parents age 65 or
older are more likely than black or Hispanic adults with aging parents
to have discussed this issue.
While a narrow majority of adults (52%) who have
discussed these topics with their parents say it was their parents who
initiated the conversations, fully a quarter say they themselves brought
up these topics. In this way their perceptions differ from the older
adults surveyed, most of whom say they are the ones to bring up these
sometimes delicate subjects.
Whether or not a provision dealing with end-of-life
medical care becomes part of a broader effort to reform the U.S. health
care system, this is an issue that affects people of all ages -- the
elderly themselves as well as their loved ones. And as the U.S.
population ages, more families will be faced with these difficult
decisions.
Aug.
27, 2009 - The national debate over health care reform has focused new
attention on the decisions people make about medical care at the end
stages of life. Public opinion polls show that Americans overwhelmingly
support an individual's right to decide whether he or she wants to be
kept alive through medical treatment. 
More
than seven-in-ten Americans (72%) said Congress should have stayed out
of the case, only 17% believed Congress had done the right thing.
One
way to insure that an individual's desires about end-of-life medical
care are carried out is to put them in writing. Nearly all Americans
know what a "living will" is, and most have given at least some thought
to their own wishes regarding medical treatment at the end of their
life. In the 2005 Pew Research survey, 35% said they've given this a
great deal of thought and 36% said they've given it some thought. Even
so, only 27% said they have put their wishes in writing and 29% said
they have a living will. Though, this represented a significant increase
from 1990 when even fewer -- 12% -- had some sort of living will. Not
surprisingly, older people are more likely than young people to have
thought about these issues and to have formalized their wishes. Half of
those ages 65 and older (51%) say their wishes for medical treatment are
written down and 54% say they have a living will.
