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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, according to a new poll released by the Pew Research Center for the People and the Press.
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.
The poll shows that people are more likely to plan for their own death today, or talk to close relatives about the subject. http://people-press.org/reports/display.php3?ReportID=266
The Terri Schindler-Schiavo case in Florida helped raise public awareness to the issue of living wills and health care proxies.
Terri, brain damaged in suspicious circumstances in 1990, died March 31 in a Pinellas County, Florida hospice after her husband petitioned the court to have her feeding tube removed, saying that she wouldn't want to be kept alive by artificial means if she became incapacitated.
Terri had not left a living will and there was no proof that she had made her wishes known to anyone. Based on self-serving hearsay by her husband, Michael Schiavo after he had received nearly $2 million in proceeds from medical malpractice claims, Pinellas County probate court judge George Greer not only ordered that Terri's feeding tube be removed, but violated the state statutes and ordered that she not be fed orally. State statues prohibit withholding food and water from an individual.
Because there was no written directive and her parents argued that she would want to live, a battle was waged in the courts for over seven years until the tube was removed by Greer's order on March 18.
According to the poll, nearly three people in 10 or 29% say they have a living will, an increase of 12% from 1990.
The poll shows that 69% of Americans say that they have talked with spouses about end-of-life issues and the medical care desired, a 50% increase from 1990.
"This probably has to do with the aging of the population and more people confronting these situations, " said Andrew Kohut, center director. "The poll found that people who have participated in decisions about end-of-life or had loved ones with illnesses in the last five years are much more likely to have thought about end-of-life treatments or to have living wills".
According to the U.S. Census, the median age in the U.S. is now 36.2, up from the 1990 average of 32.8.
Some 70% of those polled said that patients should sometimes be allowed to die which is a slight decrease from the 73% who had that opinion in 1990. Some 22% say that doctors should always try to save a patient's life.
The public is evenly divided on physician-assisted suicide, the polls shows. However, the public overwhelmingly supports laws that allow people to make their own decisions about whether they should be kept alive by artificial means.
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. Most Americans believe it should be up to individuals not the government or medical professionals to ultimately determine their end-of-life medical decisions.
The 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. 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.
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 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.
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 of the poll were:
--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. 1-6-06
© 2005 North
Country Gazette
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