The euthanasia debate: synthesising the evidence on New Zealander's attitudes

Abstract

New Zealand is considering a change in law to permit euthanasia and/or assisted dying (EAD). We reviewed 20 years of research to investigate New Zealanders' attitudes towards EAD, including those of health professionals. A systematic search was conducted using relevant databases. We identified 21 quantitative and 5 qualitative studies. For quantitative data, descriptive analyses were used to examine any demographic patterns that influenced attitudes. We reviewed the circumstances under which people think that EAD should be accessible, and which forms of EAD they support. All public attitude studies reported that the majority (68%) of respondents support EAD. There are few statistically significant demographic associations with attitudes toward EAD; exceptions include religiousity, educational attainment, and some ethnic groups. Health professionals' attitudes varied by speciality. Qualitative research was analysed for reoccurring themes; 'feeling like a burden' was evident across most studies. We conclude from the quantitative research that public attitudes are stable and a majority are open to legislative change. However, the qualitative research reveals the complexity of the issue and indicates a need for careful consideration of any proposed law changes. It is unclear what safeguards people expect if the law changes. We found little research involving vulnerable and marginalised populations.

A citizens' jury on euthanasia/assisted dying: Does informed deliberation change people's views?

“…In New Zealand, it is currently illegal for a doctor to intentionally bring about a patient's death under any circumstances or to assist a person in ending their own life. However, public awareness of and debate on these issues have intensified in recent years . In 2017, a Parliamentary Health Select Committee reported on a two‐year investigation of public attitudes on the issue, which considered over 21 000 submissions.…”

“…The jurors' responses to the New Zealand Attitudes and Values Survey question at the beginning of the process were close to what has been found amongst the general population: the national survey reports that 66% of respondents are supportive, 21.2% are unsure, and 12.3% are opposed . The reasons they gave for their respective views correspond closely with arguments laid out in the NZ and international literature …”

“…The available survey data indicate that there are no statistically significant demographic associations with attitudes to EAD amongst New Zealanders relating to age, gender or economic status, but associations with religiosity, educational attainment and certain ethnic groups . Given these findings, and given the concerns regarding the reliability of surveys in gauging views on this matter, it is possible that certain groups would respond differently to the perspectives and arguments put forward by the experts and that their deliberation would produce a different result.…”

“…However, public awareness of and debate on these issues have intensified in recent years. 10 In 2017, a Parliamentary Health Select Committee reported on a two-year investigation of public attitudes on the issue, which considered over 21 000 submissions. The report showed both strong support for and opposition to a law change, and that the concerns and arguments raised by submitters closely correspond to those raised in international debate.…”

Grounded ethical analysis

“…The aid in dying (or euthanasia) debate continues and there are now many jurisdictions where this is permitted and others where proposed legislation is under consideration 7. Palliative care is, perhaps, the specialty that is likely to be most affected by legalised aid in dying or euthanasia and it usually opposes legalisation.…”