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The European Journal of Public Health Advance Access published online on April 26, 2006
The European Journal of Public Health, doi:10.1093/eurpub/ckl042
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© The Author 2006. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Received August 22, 2005
Accepted February 6, 2006

Article

Trends in acceptance of euthanasia among the general public in 12 European countries (1981-1999)

Joachim Cohen 1 *, Isabelle Marcoux 2, Johan Bilsen 3, Patrick Deboosere 4, Gerrit van der Wal 5, and Luc Deliens 6

1 End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium
2 Centre for Research and Intervention on Suicide and Euthanasia, University of Quebec at Montreal, Montreal, Canada; VU University Medical Center, Department of Public and Occupational Health, EMGO Institute, Amsterdam, the Netherlands
3 End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium; Centre for Environmental Philosophy and Bioethics, Ghent University, Ghent, Belgium
4 Faculty of Economic, Social and Political Sciences, Department of Social Research, Interface Demography, Vrije Universiteit Brussel, Brussels, Belgium
5 VU University Medical Center, Department of Public and Occupational Health, EMGO Institute, Amsterdam, the Netherlands
6 End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium; VU University Medical Center, Department of Public and Occupational Health, EMGO Institute, Amsterdam, the Netherlands

* To whom correspondence should be addressed.
Joachim Cohen, E-mail: Joachim.Cohen{at}vub.ac.be


  Abstract

Background: We wanted to examine how the acceptance of euthanasia among the general public in Western Europe has changed in the last decades, and we wanted to look for possible explanations. Methods: We analysed data from the European Values Surveys, held in 1981, 1990, and 1999-2000 in 12 West European countries. In each country, representative samples of the general public were interviewed using the same structured questionnaire in all countries. Euthanasia was explained in the questionnaires as ‘terminating the life of the incurably sick’. Results: A total of 46 199 respondents participated in the surveys. A significant increase in acceptance of euthanasia could be observed in all countries except (West) Germany. While the average increase in euthanasia acceptance was 22%, the increase was particularly obvious in Belgium, Italy, Spain, and Sweden. Although changes in several characteristics of respondents, such as decrease in religious beliefs, rising belief in the right to self-determination, and (to a lesser extent) rise in levels of education, were associated with growing acceptance of euthanasia, they could only partly explain the increase of euthanasia acceptance over the years. Conclusions: An increase of euthanasia acceptance among the general public took place over the last two decades in almost all West European countries, possibly indicating a growing support for personal autonomy regarding medical end-of-life decisions. If this trend continues, it is likely to increase the public and political debate about the (legal) regulation of euthanasia under certain conditions of careful medical practice in several West European countries.

Keywords: attitudes of general public; cross-national research; European values; euthanasia; trends.
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