ANN ARBOR—Most Michigan physicians would legalize physician-assisted suicide rather than ban it, according to a year-long University of Michigan study published in the current The report was based on responses of 1,119 physicians and 998 members of the general public, surveyed in 1994 and 1995 by U-M research scientist Jerald G. Bachman and colleagues.

The surveys asked whether the Michigan Legislature, which has been confronting the issue for several years, should ban all physician- assisted suicide or legalize it under various conditions. Multiple versions of questionnaires were used in order to explore various options for legalization, and to check for possible effects of different question wordings.

However, results were highly similar across questionnaires, so they were combined for these analyses. For both the physician and public samples, the margin of error is 3 percent. When asked to choose between closely regulated physician- assisted suicide and a complete ban, 56 percent of physicians and 66 percent of the general public chose legalization, 37 percent of physicians and 26 percent of the public thought it should be banned, and small proportions were uncertain.

Physicians were given a wider range of choices later in their questionnaires. In response, 40 percent favored a law permitting physician-assisted suicide, 17 percent favored a law banning it, and 37 percent favored having no law, leaving it either to the doctor-patient relationship (22 percent) or to medical profession regulations or guidelines (15 percent).

When asked whether they themselves would be willing to participate in physician-assisted suicide, or in voluntary euthanasia (in which the physician rather than the patient ” takes the final action”), 52 percent of physicians said they would not participate in either, 13 percent said they might participate only in assisted suicide, and 22 percent said they might participate in both. (Ten percent were uncertain, and 2 percent preferred not to answer.) Among those physicians who would not participate themselves, 43 percent said they would be willing to refer patients to another physician, while 38 percent would not (and 19 percent were uncertain).

The surveys gave people several chances to express their preferences for different plans or different types of controls and safeguards. ” Physicians, as well as the general public, were most supportive of plans which included careful consultations with other physicians and extensive additional safeguards,” Bachman pointed out. The authors noted that their results have several policy implications.

“On the one hand, given the overall stability of our findings during a year when assisted suicide was widely debated in Michigan, it appears unlikely that any new plan for legalization could win over large numbers of heretofore reluctant physicians, voters or legislators.

“On the other hand, physicians who support carefully safeguarded legalization of physician-assisted suicide clearly outnumber those who support a total ban, and the same is true for Michigan adults in general.

Moreover, many would also support voluntary euthanasia, especially for patients unable to act for themselves. ” These complex issues should not be decided by opinion polls,” the authors concluded, “but neither should political decision makers simply ignore the strongly held views of those who will be most affected by legislative decisions on this question” physicians and their potential patients.”

Bachman and co-investigators Kirsten H. Alcser, David J. Doukas, Richard L. Lichtenstein and Amy D. Corning are all affiliated with the U-M Institute for Social Research. Doukas is also at the U-M Medical School Department of Family Practice, and Lichtenstein is also at the U-M School of Public Health. Co-investigator Howard Brody is a professor of family practice at Michigan State University, and also was the chairman of the Michigan Commission on Death and Dying. The research was funded by a grant from the Blue Cross and Blue Shield of Michigan Foundation.

Related Links:

• School of Public Health
• Institute for Social Research