Religion and attitudes towards euthanasia in Britain: Evidence from opinion polls and social surveys

The issue of euthanasia or assisted dying formed the basis of one of the 2013 Westminster Faith Debates on religion and personal morality. An accompanying survey of adults in Britain – conducted by YouGov in January 2013 – found that public support for euthanasia was very strong: 70% being in favour, 16% opposed and 14% undecided (a more detailed discussion of these findings – including the reasons underlying the opposing positions taken – is available here). What about public attitudes over time on this issue? In particular, what have been the views of religious groups – both in terms of belonging but also based on other aspects, such as religious practices and beliefs? This post reviews the historical data on religious groups’ views towards euthanasia, using evidence from both national opinion polls and social surveys. Three main sources are used, which between them allow analysis of different question wordings and response options on this issue:

• NOP polls conducted between the 1970s and 1990s.
• European Values Study (EVS) surveys for the period 1981-2008.
• British Social Attitudes (BSA) surveys undertaken between 1983 and 2012.

The data presented here will hopefully be of use to those interested in religious groups’ attitudes towards euthanasia in particular or towards social-morality issues in general. Before commenting on the data, it is worth making a couple of general observations. First, euthanasia is generally understood to mean the voluntary ending of an individual’s life, usually to relieve incurable and painful suffering. Second, the ending of life in these circumstances could be achieved by: (a) the individual, if physically capable of doing so; (b) with the assistance of a doctor or other medical professional; or (c) with the assistance of a friend or relative. The questions on which the NOP and BSA time series data are based clearly refer to scenario (b), but the EVS question is less well-defined.

NOP OPINION POLLS

Firstly, a series of polls conducted by NOP for the Voluntary Euthanasia Society (which became Dignity in Dying in 2006) from the 1970s into the 1990s provide valuable data on religious groups’ attitudes towards euthanasia. Respondents were asked whether they (strongly / moderately) agreed or (strongly / moderately) disagreed with the following statements (note the slight variation in wording for some surveys):

• 1976: People say the law should allow adults to receive medical help to an immediate peaceful death if suffering from incurable physical illness that is intolerable to them, provided they have previously requested such help in writing.
• 1978: If a patient is suffering from a distressing and incurable physical illness, a doctor should be allowed to supply that patient with the means to end his own life if the patient wishes to.
• 1985: Some people say that the law should allow adults to receive medical help to an immediate peaceful death, if they suffer from an incurable physical illness that is intolerable to them, provided they have previously requested such help in writing.
• 1989: Some people say that the law should allow adults to receive medical help to an immediate peaceful death if they suffer from an incurable physical illness that is intolerable to them, provided they have previously requested such help in writing?
• 1993: Some people say that the law should allow adults to receive medical help to a peaceful death if they suffer from an incurable physical illness that is intolerable to them, provided they have previously requested such help in writing. 

Data are presented in Table 1, which reports the proportions disagreeing in each of the five polls undertaken between 1976 and 1993. The final column shows the percentage point change over time. Table 1 shows the results for a variety of Christian denominations, as well as those who reported that they were ‘atheist’ or ‘agnostic’ (or did not know). Affiliation categories for which there were generally few or very few individuals in the surveys are not shown. A few interesting findings present themselves. First, levels of disagreement are generally higher for Catholics in the earlier surveys compared to other Christians denominations (particularly Anglicans and Methodists). Second, opposition is usually lowest amongst Atheists and Agnostics, as well as Anglicans and those who responded ‘don’t know’, again more evident in the earlier surveys. Agnostics show very little opposition in the earlier surveys, lower than that registered by Atheists. Third, on no occasion is disagreement a majority view amongst any of the groups – peaking at 43% for Catholics in 1978. Fourth, all religious groups show declining levels of disagreement over time, although the percentage point changes vary in magnitude (see final column). For example, disagreement amongst Catholics declined by 17.0 points compared to 5.0 and 6.0 points, respectively, for Anglicans and Methodists.

Table 1 Per cent disagreeing with euthanasia by affiliation (NOP polls)

Source: NOP opinion polls (data kindly supplied by Dr Clive Field).

^aThis category is not functionally equivalent with the other years, as in 1978 it included other non-conformist traditions (including Baptists, Congregationalists and United Reformed) as well as Methodists.

The NOP data therefore show that opposition to euthanasia – as expressed in response to the question used here –  was very much a minority view across various religious traditions, as well amongst as those who said they were an ‘atheist’ or an ‘agnostic’. Moreover, the levels of opposition clearly fell over time. Several opinion polls have been undertaken by YouGov for Dignity in Dying in recent years, including one in April 2013.

EVS SURVEYS

What about other attitudinal data on this issue, this time taken from recurrent social surveys? And what do such data tell us about views on euthanasia based on measurement of religious practice and beliefs? The EVS surveys, with four waves spanning the period 1981-2008, have gauged views on euthanasia by asking a question about whether euthanasia is justified. It is worded as follows:

Please tell me for each of the following statements whether you think it can always be justified, never be justified, or something in between … Euthanasia (terminating the life of the incurably sick).

Respondents are asked to place themselves on a scale ranging from 1 to 10. On this scale 1 represents a position where euthanasia is never justified and 10 represents a position where it is always justified. Given this type of measuring instrument, we can present the mean scores on this scale for various aspects of personal religion: affiliation, attendance at services, membership, broad-based identity and belief in God. Table 2 reports the mean scores for each of the four surveys (1981, 1990, 1999 and 2008) as well as showing the  change over time in these scores in the final column. To reiterate, higher scores represent greater acceptance of euthanasia.

Looking at affiliation, those who do not report a religious belonging are most likely to have seen euthanasia as justifiable, followed by Anglicans. Catholics have generally been less likely to see it as justifiable, as have other Christians (the data for non-Christian faiths are not reported here as they have constituted small numbers of respondents in the EVS surveys). We also see variation in average scores on the basis of other measures of religion: those less likely to accept the justifiability of euthanasia include frequent-attenders (defined here and subsequently as once a month or more), members of churches or religious organisations, those who self-identify as a religious person, and those who profess a belief in God. Again, the general picture is that the climate of opinion becomes more accepting of euthanasia, and this occurs across the various measures of personal religion. Even so, the change over time is much less pronounced for frequent-attenders and those who profess membership of a church or religious organisation. The increases are larger for the three categories of religious belonging compared to those with no affiliation, given the latter’s greater acceptance from the outset.

Table 2 Mean scale scores for whether euthanasia is justifiable or not by various indicators of religion (EVS surveys)

Source: EVS surveys. Weighted data.

^a  Note that this category for the 1981 survey covers Protestant traditions apart from Non-conformists. For all subsequent surveys, Non-conformists and other Christian traditions fall within the ‘other Christian’ category.

BSA SURVEYS

In addition to the over-time data from the EVS, the BSA surveys have asked a consistently-worded question on euthanasia on several occasions since 1983. It reads as follows:

About a person with a painful incurable disease. Do you think that doctors should be allowed, by law to end the patient’s life, if the patient requests it?

Respondents were able to give a ‘yes’ or ‘no’ response (or reply ‘don’t know’). Data are presented for both affiliation and frequency of attendance (with the percentage point changes again reported in the final column). Table 3 reports the proportions who responded ‘no’ in each survey from 1983 to 2012. Looking at the results for affiliation, we can see that, as is evident above, Catholics have been more likely to oppose euthanasia compared to Anglicans and those with no religion. They have also registered higher levels of opposition than other Christians, until the more recent surveys. As with the NOP and EVS data, moreover, all groups show declining opposition over time – most marked for Catholics (a fall of 12.8 percentage points). Based on frequency of attendance at religious services (for which data are currently available until 2005), there are clear and sustained differences over time. Specifically, frequent-attenders show higher levels of opposition (around two-fifths in most surveys saying ‘no’), with infrequent attenders showing lower levels of opposition and being closer in their views to non-attenders, of whom only small minorities respond ‘no’.

Table 3 Per cent saying ‘no’ to euthanasia by affiliation and attendance (BSA surveys, 1983-2012)

Source: BSA surveys. Weighted data.

^a Data on attitudes by attendance for the 2012 survey are not yet available.

The BSA series also asked an additional question on euthanasia, only fielded on surveys in the 1980s. It was worded as follows:

About a person who is not incurably sick but simply tired of living. Do you think that doctors be allowed by law to end that person’s life if he or she requests it?

Note the important different in question wording, referring to a person being ‘not incurably sick but simply tired of living’. Does this change affect levels of opposition? Data for religious affiliation are shown in Table 4. Levels of opposition are much higher in response to this question wording; in fact, there is overwhelming opposition to euthanasia in such circumstances. Those with no religious affiliation are a little less likely to be against, but around four-fifths are opposed in each survey. For Anglicans, Catholics and other Christians, proportions approaching nine-tenths of each groups –and sometimes higher – register opposition to euthanasia on such grounds. Albeit covering a much shorter duration, the data show little change in views over time (from 1983 to 1989). When classified by attendance, those who never attend services show slightly lower levels of opposition compared to infrequent or frequent attenders, although negative sentiment is broadly similar in the 1989 survey.

Table 4 Per cent saying ‘no’ to euthanasia by affiliation and attendance (BSA surveys, 1983-1989)

Source: BSA surveys. Weighted data.

Finally the 2008 BSA survey offers a snapshot of religious groups’ views. It featured two specialist modules on religion (for the International Social Survey Programme and Faith Matters), administering this question on the ISSP module.

Suppose a person has a painful incurable disease. Do you think that doctors should be allowed by law to end the patient’s life, if the patient requests it?

While the question wording is somewhat similar to the first BSA question discussed above, a different set of response options were used: ‘definitely should be allowed’, ‘probably should be allowed’, ‘probably should not be allowed’ and ‘definitely should not be allowed’ (as well as ‘don’t know). Table 5 reports the distribution of opinion for a various indicators of religion, (affiliation, frequency of attendance, frequency of prayer – defined as every week or more, whether considers themselves a religious person, takes part in church activities aside from regular worship, and belief in God). The options have been collapsed into broader ‘should be allowed’ and ‘should not be allowed’ categories. There is majority support for allowing euthanasia across all categories, although there is still considerable variation in the proportions who think it should be allowed. Opposition is highest amongst members of non-Christian religions, frequent-attenders, those who pray regularly, those who seem themselves as religious, those who frequently take part in church activities (defined as once a month or more), and those who express a belief in God. The proportions responding ‘don’t know’ are generally on the low side (highest at 6.1% for other Christians and 5.6% for frequent attenders).

Table 5 Whether euthanasia should or should not be allowed by various indicators of religion (BSA 2008 survey)

Source: BSA 2008 survey (ISSP module). Weighted data.

Summary

Overall, we can see that opposition towards euthanasia has decreased in recent decades, and this has occurred based on different questions sourced from opinion polls and recurrent social surveys. Even amongst those who show greater personal engagement with religion – whether through personal or communal practice or belief – opposition to euthanasia is a minority viewpoint. In terms of belonging, Catholics have tended to show higher levels of opposition, particularly in earlier surveys, with Anglicans less opposed and those with no religion least opposed. Because support for euthanasia for individuals with incurable conditions or diseases has traditionally been a majority viewpoint for religious groups since the 1970s, with opposition being expressed by a minority, we do not see such strong liberalising trends as have been evident in religious opinion towards other social-moral issues – such as homosexuality and gay rights – in recent decades.

Further reading

The BSA data analysed here by no means exhaust the questions asked on the topic of euthanasia in this series. More detailed sets of questions were administered in the 1995 and 2005 BSA surveys, and were analysed in the following publications:

Clery, E., McLean, S. and Phillips, M. (2007), ‘Quickening death: The euthanasia debate’, in A. Park et al (eds), British Social Attitudes: 23^rd Report. Perspectives on a Changing Society, London: Sage, pp. 35-54.

Donnison, D. and Bryson, C. (1996), ‘Matters of Life and Death: Attitudes to Euthanasia’, in Jowell, R., Curtice, J., Park A., Brook, L. and Thomson, K. (eds.), British Social Attitudes: the 13th Report. Aldershot: Dartmouth, pp.

For analysis of U.S. public opinion on this topic, see:

Green, J. A. and Jarvis, M. G. (2008), ‘The right to die’, in N. Persily, J. Citrin and P. Egan (eds), Public Opinion and Constitutional Controversy. New York: OUP, pp. 267-285.

A recent cross-national study of public attitudes is:

Cohen, J., Marcoux, I., Bilsen, J., Deboosere, P., van der Wal, G. and Deliens, L. (2006), ‘European public acceptance of euthanasia: Socio-demographic and cultural factors associated with the acceptance of euthanasia in 33 European countries’, Social Science & Medicine, 63(3): 743-756.