Euthanasia: why people want to die earlier.

The results from two surveys in England of relatives and others who knew people in samples drawn from death certificates are reported. The main focus is on a sample of 3696 people dying in 1990 in 20 health authorities, with supporting analysis from an earlier national sample of 639 people dying in 1987. The incidence of people saying they wanted to die sooner, and of requests for euthanasia are reported. Excluding a proportion who did not wish to express a view, or did not know the answer, about a quarter of both respondents and the people who died expressed the view that an earlier death would be, or would have been, preferable. 3.6% of people in the 1990 study were said to have asked for euthanasia at some point in the last year of life. The extent to which such views were determined by the experience of pain, other distressing symptoms, dependency and social and cultural factors such as religious belief and social class is explored. The finding that dependency was important in causing the feeling that an earlier death would have been better, as well as requests for euthanasia, is related to the public debate about euthanasia, which often contains the assertion that fear of pain is a dominant factor. Pain was found to be a significant factor in death from cancer, but not as important for other causes of death. Social class, place of residence of the deceased, and strength and type of religious faith were found to be largely insignificant in influencing feelings about an earlier death and requests for euthanasia.