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Senior Citizen Attitudes on Right to Die Issues are Surprising

Older Americans less likely to say a person has right to take their life

By Tucker Sutherland, editor

Jan. 9, 2006 – The opinions of senior citizens about "right to die" issues surprised me in the survey results released last week by the Pew Research Center. Those 65 and older in the survey were much less likely than younger people to say a person has the right to take their own life, even when suffering great pain and with no hope for improvement. Only 50 percent of seniors say a person has this right, while 62 percent of younger people say they do. (See charts below story.)

An overwhelming majority of the public supports laws that give patients the right to decide whether they want to be kept alive through medical treatment. And fully 70% say there are circumstances when patients should be allowed to die, while just 22% believe that doctors and nurses should always do everything possible to save a patient. Interestingly, seniors were less likely than all but the youngest age group to agree there are times when a patient should be allowed to die.

"Public attitudes on these and many other end-of-life issues are unchanged from 1990, despite advances in lifesaving technology, the aging of the population, and the controversy associated with the Terri Schiavo case," they survey authors say.

But, there are some big changes in attitude among senior citizens. In 1990, for example, only 13% of seniors thought everything possible should be done to save a life. In 2005, this percentage had grown to 20.

When seniors were asked in 1990 if a person has a moral right to end his or her own life when suffering great pain and has no hope for improvement, only 39% agreed. This has now increased to 50%.

So, while the researchers found little change in the general public's attitude, senior citizens have clearly increased their value on survival – under any circumstance.

A gigantic shift for seniors is in having a living will. In 1990 only 19% said they had such a document, which is generally used for leaving instructions for treatment should the person become incapable of making decisions. By the end of 2005, this number has grown to over half – 54%. Not surprisingly, this is far in excess of younger people.

	Do you think a person has a moral right to end his or her own life When suffering great pain and has no hope for improvement?

Public awareness of living wills, already widespread in 1990, is now virtually universal, and the number saying they have a living will has more than doubled - from just 12% in 1990 to 29% today.

The Pew Research Center's survey, conducted Nov. 9-27, 2005 among 1,500 adults, finds that while overall attitudes are largely stable, people are increasingly thinking about - and planning for - their own medical treatment in the event of a terminal illness or incapacitating medical condition.

People also are much more willing to discuss sensitive end-of-life issues with their loved ones than they were a generation ago. Nearly seven-in-ten (69%) of those who are married say they have had a conversation with their husband or wife about their spouse's wishes for end-of-life medical care; only about half reported doing so in 1990 (51%). Among those with living parents, 57% say they have spoken with their mother ­ and 48% with their father ­ about the parent's requests for end-of-life treatment.

Most Americans believe it should be up to individuals - not the government or medical professionals - to ultimately determine their end-of-life medical decisions.

There is strong sentiment in favor of letting close family members decide whether to continue medical treatment for a terminally ill loved one who is unable to communicate their own wishes. Roughly three-quarters (74%) say a family member should be permitted to make this decision, which is little changed from 1990 (71%).

But Americans make a distinction between allowing a terminally ill person to die and taking action to end someone's life. The public is deeply divided over legalizing physician-assisted suicide; 46% approve of laws permitting doctors to help patients to end their lives, while about as many are opposed (45%).

Though most Americans say it is sometimes morally acceptable for people with dire medical conditions to take their own lives, acceptance of this practice is highly dependent on circumstances.

Six-in-ten in the general public feel that people have a moral right to end their lives if they suffer from great pain and have no chance for improvement. But this view changes under less extreme circumstances. For example, just 29% say a person has a moral right to end their life if he or she has become burdensome to family, with 62% saying someone in that situation does not have a moral right to take their life. (See chart by age group.)

The survey finds that in many ways, public attitudes toward death and dying defy easy categorization. A majority believes that it is at least sometimes justifiable for a person to kill their spouse, again in extreme circumstances. Roughly six-in-ten (61%) feel that the 'mercy killing' of a spouse is always (6%) or sometimes (55%) justified, if the spouse "was suffering terrible pain from a terminal disease." About half as many (29%) say such an act is never justified, although that represents a significant increase since 1990 (20%).

People's views of end-of-life policies and practices do not perfectly mirror their own treatment preferences.

While there has been an increase since 1990 in the percentage saying that people generally have a moral right to end their own life if they are facing an incurable illness and great pain (from 55% in 1990 to 60% now), there has also been an increase in the percentage who say they would personally want everything possible done to save their lives in many situations.

About a third (34%) now say they would tell their doctor to do "everything possible" to save their life even if faced with a terminal illness and great pain; in 1990, fewer (28%) indicated they wanted everything done to save them in that case.

Other Findings

  ● People who have helped make end-of-life medical treatment decisions for loved ones are more likely than others to have a living will or to have discussed their wishes for end-of-life care. In addition, more of those who have gone through this experience believe in a moral right to suicide in certain circumstances, and favor ending their own medical treatment in the face of an incurable disease and great pain.

  ● By a wide margin, the public continues to disapprove of congressional action in 2005 that directed the federal courts to hear the case of Terri Schiavo, the brain-damaged Florida woman who later died after her feeding tube was removed.

  ● The Democratic Party has a modest advantage with the public in dealing with end-of-life issues. About one-third (34%) say the Democrats could do a better job with such issues, while 22% favor the Republicans.

  ● There is very little consistency in public attitudes toward what have been characterized as "life" issues ­ abortion, the death penalty, and end-of-life questions. However, abortion opponents, and opponents of the death penalty, are more likely than those who accept these practices to favor doing everything possible to save a life regardless of the circumstances, as well as to oppose physician-assisted suicides.

  ● By more than eight-to-one (84%-10%), the public approves of laws that let terminally ill patients make decisions about whether to be kept alive through medical treatment. This represents a small but significant increase in support for right to die laws since 1990 (79%).

The increase in support has been more pronounced among those over the age of 50 (from 72% to 83% approval), white Catholics (from 80% to 91% approval), and among those who have given a great deal of thought to end-of-life issues (from 79% to 87% approval).

  ● In instances where a terminally ill patient is unable to communicate, the public supports allowing the closest family member to decide whether to continue medical treatment; 74% agree with this approach, while only 15% say that relatives should not be allowed to make such decisions. Here, too, the public is united across political and demographic lines, with approximately three-quarters of Republicans (72%), Democrats (78%), and independents (74%) saying that family members should be able to make treatment decisions for sick relatives.

  ● Though Americans are broadly supportive of allowing patients and their families to decide whether medical treatment should be removed, the public is divided over laws that let doctors prescribe lethal doses of drugs to assist terminally ill patients end their lives. Nearly half (46%) approve of such laws, while about as many (45%) disapprove.

On this issue, Americans are divided along religious and political lines. By two-to-one (61%-30%) white evangelical Protestants oppose physician-assisted suicide laws; by nearly identical margins, white mainline Protestants and seculars approve of such laws. Catholics, on balance, oppose such laws (by 50%-40%).

Key Charts

TREND: DO EVERYTHING TO SAVE LIFE, OR SOMETIMES LET PATIENT DIE?

Which comes closer to your view? In all circumstances, doctors and nurses should do everything possible to save the life of a patient, OR sometimes there are circumstances where a patient should be allowed to die.

Do you think a person has a moral right to end his or her own life under any of the following circumstances:

What would you tell your doctor to do if you…