Relatives keener on euthanasia than patients

BMJ 1994; 309 doi: (Published 29 October 1994) Cite this as: BMJ 1994;309:1107
  1. L Dillner

    People in Britain are more likely to request euthanasia to avoid being a burden to their relatives than because they are in pain, according to a new study. Clive Seale, a lecturer in the sociology of medicine at Goldsmith's College, London, and Julia Addington-Hall, an epidemiologist from University College London, asked 2192 people who had recently been bereaved about their experiences. They were asked whether the dying person had expressed a wish to die earlier and whether he or she had requested euthanasia.

    Relatives were asked whether the person would have benefited from an earlier death. Over a third of the respondents were spouses; nearly half were other relatives; and the remainder were friends, neighbours, or officials such as wardens of sheltered accommodation.

    Overall 28% of respondents said that it would have been better for the person to have died earlier. Spouses were the least likely to think that the person should have died earlier, and this remained true after the person's age and levels of pain and dependency had been controlled for. Children, friends, and officials were more likely to say that an earlier death would have been desirable.

    Less than 4% of the people who died had expressed a wish for euthanasia, though nearly a quarter had expressed some desire for an earlier death. The researchers write in the Journal of Social Science and Medicine: “Respondents who were not spouses were more willing to say that an earlier death would have been better even though the person son who died had not said they wanted to die sooner.” There were no differences in responses between those people with religious beliefs and those without.

    The desire to die sooner was associated with higher levels of dependency and being who received hospice services were twice as likely as others to have asked for euthanasia at some point during their last year.

    “This is the first substantial report to look at the views of people who have been through berevement,” said Clive Seale. “Most of the opinion polls suggest a religious element to people's objections to euthanasia. We find that religion makes no difference when people are considering what they want for themselves. Opinion polls can only ask in the abstract - our study finds out what actually happened when these people died. The study shows that there is not a simple relationship between quality of care and the wish to die. It's more complicated than simply providing good care. People in hospices feel more able to talk about death.”

    Seale said that the study did not support or condemn euthanasia. “It does provide some evidence for those who oppose euthanasia because they fear that elderly and vulnerable people can be abused. It shows that there are old people being looked after by people who don't have a large emotional investment in their lives continuing and are able to see the positive side of their dying earlier.”

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