Opinion polls of public and doctors have been a feature of the debate over legalising euthanasia and assisted suicide since the early 1950s. The winners of course place great stock on the outcomes. However, research by professional pollsters shows clearly that the way a question is worded influences the answer. Gallup for example, has run regular public polls on this issue for many years and has found that public support for euthanasia for a person living with incurable severe pain drops from about 70% when the doctors intervention is euphemistically described as ending the patients life by some painless measure to 50% when it is described as assistance to commit suicide .2 Others have found even more drastic falls (to about 10%) when the question is personalised rather than hypothetical.3This euphemistic factor impacts on Dr Havills poll because it asks about a medical practitioner giving assistance to die on request . What does this mean? Isnt that what every general practitioner is frequently called upon to do? Does assistance to die include, in Havills mind, killing the patient? If it does, why isnt Havill prepared to say so for the sake of clarity, rather than resort to euphemisms?A second difficulty with this poll is that question 1 is prefaced by the statement: Given adequate safeguards against abuse, do you support\u2026. The problem there is that nowhere in the world where euthanasia or assisted suicide are legal has it been possible to set in place legal safeguards against abuse. Thus, for example, in Belgium which has legislation similar to the End of Life Choice Bill of Maryan Street about one third of assisted suicides are carried out without any request from the patient.4 A proportion of those patients were judged to have been capable of making a request had they chosen to do so. In Oregon doctor shopping aided by Compassion and Choices as a way of circumventing the legislation is common.5 Anyone responding to this question as worded would do so under a false sense of security. It would be much more realistic to preface any further polling with: Given that adequate safeguards against abuse cannot be guaranteed, or words to that effect.Finally, I wonder why in the tabular presentation of results Dr Havill combined the two end categories of his five-point scale. We could possibly have learned something very important about the numbers that fully support his propositions on the one hand and that totally opposed them on the other had he reported the results without this modification.
- - Havill JA. Physician-assisted dying - a survey of Waikato general practitioners. NZMJ. 2015, Feb.20; 128 (1409): 70-1. http://www.gallup.com/poll/162815/support-euthanasia-hinges-described.aspx Emanuel EJ, Fairclough DL, Emanuel LL. Attitudes and desires related to euthanasia and physician assisted suicide among terminally ill patients and caregivers. JAMA. 2000, 284: 2460-68. Chambaere K, Bilsen J, Cohen J et al. Physician-assisted deaths under the euthanasia law in Belgium: a population based study. CMAJ. 2010 June 15; 182(9): 895 - 901. Stevens KR. The proportion of Oregon assisted suicides by Compassion and Choices organisation. Portland: Physicians for Compassionate Care Education Foundation 2009 March 4. Available at: http://www.pccef.org/DOWNLOADS/AssistedsuicidesbyCC2009report.pdf.- -
Opinion polls of public and doctors have been a feature of the debate over legalising euthanasia and assisted suicide since the early 1950s. The winners of course place great stock on the outcomes. However, research by professional pollsters shows clearly that the way a question is worded influences the answer. Gallup for example, has run regular public polls on this issue for many years and has found that public support for euthanasia for a person living with incurable severe pain drops from about 70% when the doctors intervention is euphemistically described as ending the patients life by some painless measure to 50% when it is described as assistance to commit suicide .2 Others have found even more drastic falls (to about 10%) when the question is personalised rather than hypothetical.3This euphemistic factor impacts on Dr Havills poll because it asks about a medical practitioner giving assistance to die on request . What does this mean? Isnt that what every general practitioner is frequently called upon to do? Does assistance to die include, in Havills mind, killing the patient? If it does, why isnt Havill prepared to say so for the sake of clarity, rather than resort to euphemisms?A second difficulty with this poll is that question 1 is prefaced by the statement: Given adequate safeguards against abuse, do you support\u2026. The problem there is that nowhere in the world where euthanasia or assisted suicide are legal has it been possible to set in place legal safeguards against abuse. Thus, for example, in Belgium which has legislation similar to the End of Life Choice Bill of Maryan Street about one third of assisted suicides are carried out without any request from the patient.4 A proportion of those patients were judged to have been capable of making a request had they chosen to do so. In Oregon doctor shopping aided by Compassion and Choices as a way of circumventing the legislation is common.5 Anyone responding to this question as worded would do so under a false sense of security. It would be much more realistic to preface any further polling with: Given that adequate safeguards against abuse cannot be guaranteed, or words to that effect.Finally, I wonder why in the tabular presentation of results Dr Havill combined the two end categories of his five-point scale. We could possibly have learned something very important about the numbers that fully support his propositions on the one hand and that totally opposed them on the other had he reported the results without this modification.
- - Havill JA. Physician-assisted dying - a survey of Waikato general practitioners. NZMJ. 2015, Feb.20; 128 (1409): 70-1. http://www.gallup.com/poll/162815/support-euthanasia-hinges-described.aspx Emanuel EJ, Fairclough DL, Emanuel LL. Attitudes and desires related to euthanasia and physician assisted suicide among terminally ill patients and caregivers. JAMA. 2000, 284: 2460-68. Chambaere K, Bilsen J, Cohen J et al. Physician-assisted deaths under the euthanasia law in Belgium: a population based study. CMAJ. 2010 June 15; 182(9): 895 - 901. Stevens KR. The proportion of Oregon assisted suicides by Compassion and Choices organisation. Portland: Physicians for Compassionate Care Education Foundation 2009 March 4. Available at: http://www.pccef.org/DOWNLOADS/AssistedsuicidesbyCC2009report.pdf.- -
Opinion polls of public and doctors have been a feature of the debate over legalising euthanasia and assisted suicide since the early 1950s. The winners of course place great stock on the outcomes. However, research by professional pollsters shows clearly that the way a question is worded influences the answer. Gallup for example, has run regular public polls on this issue for many years and has found that public support for euthanasia for a person living with incurable severe pain drops from about 70% when the doctors intervention is euphemistically described as ending the patients life by some painless measure to 50% when it is described as assistance to commit suicide .2 Others have found even more drastic falls (to about 10%) when the question is personalised rather than hypothetical.3This euphemistic factor impacts on Dr Havills poll because it asks about a medical practitioner giving assistance to die on request . What does this mean? Isnt that what every general practitioner is frequently called upon to do? Does assistance to die include, in Havills mind, killing the patient? If it does, why isnt Havill prepared to say so for the sake of clarity, rather than resort to euphemisms?A second difficulty with this poll is that question 1 is prefaced by the statement: Given adequate safeguards against abuse, do you support\u2026. The problem there is that nowhere in the world where euthanasia or assisted suicide are legal has it been possible to set in place legal safeguards against abuse. Thus, for example, in Belgium which has legislation similar to the End of Life Choice Bill of Maryan Street about one third of assisted suicides are carried out without any request from the patient.4 A proportion of those patients were judged to have been capable of making a request had they chosen to do so. In Oregon doctor shopping aided by Compassion and Choices as a way of circumventing the legislation is common.5 Anyone responding to this question as worded would do so under a false sense of security. It would be much more realistic to preface any further polling with: Given that adequate safeguards against abuse cannot be guaranteed, or words to that effect.Finally, I wonder why in the tabular presentation of results Dr Havill combined the two end categories of his five-point scale. We could possibly have learned something very important about the numbers that fully support his propositions on the one hand and that totally opposed them on the other had he reported the results without this modification.
- - Havill JA. Physician-assisted dying - a survey of Waikato general practitioners. NZMJ. 2015, Feb.20; 128 (1409): 70-1. http://www.gallup.com/poll/162815/support-euthanasia-hinges-described.aspx Emanuel EJ, Fairclough DL, Emanuel LL. Attitudes and desires related to euthanasia and physician assisted suicide among terminally ill patients and caregivers. JAMA. 2000, 284: 2460-68. Chambaere K, Bilsen J, Cohen J et al. Physician-assisted deaths under the euthanasia law in Belgium: a population based study. CMAJ. 2010 June 15; 182(9): 895 - 901. Stevens KR. The proportion of Oregon assisted suicides by Compassion and Choices organisation. Portland: Physicians for Compassionate Care Education Foundation 2009 March 4. Available at: http://www.pccef.org/DOWNLOADS/AssistedsuicidesbyCC2009report.pdf.- -
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