What Do I Know?

By John Benson

In two recent high-profile cases, the Terri Schiavo case and Gonzalez v. Oregon (the Supreme Court case involving Oregon’s Death With Dignity Act), courts have sided with right-to-die proponents. But those who believe in a right to die should not get overconfident. The demographics and politics of this issue, including the active role being played by the right-to-life movement, make it likely that the issue is not going to go away.

In a 1999 “Polls” article in Public Opinion Quarterly, I made the following statement:

The right-to-life movement, which played an important role in end-of-life debates as far back as the Nancy Cruzan case in the late 1980s, has begun to focus even more attention on the end of life. Antiabortion forces have been in the forefront of opposition to physician-assisted suicide referenda and are the main impetus for “lethal dose” legislation that would use drug-control laws to make it illegal for a doctor to prescribe enough painkillers to help a patient commit suicide. In addition, they have been pursuing laws that would limit the ability of relatives to halt the artificial feeding or life support of patients who cannot make such decisions themselves.

This is exactly what we have seen in the Schiavo and Gonzalez cases during the past year.

As polls conducted during the spring of 2005 showed, a majority of the American public opposed efforts by elected politicians to intervene in the Schiavo case. This finding was reaffirmed in a recent Pew Research Center poll, in which 72 percent said that Congress should have stayed out of the case. But the public was somewhat more divided on the question of whether Schiavo’s feeding tube should have been removed. A substantial minority of the public opposed removal.

As for attitudes about physician-assisted suicide (PAS), the public opinion story is made more complex by the tendency to apply that term to two separate processes: PAS, narrowly defined, where the patient takes his or her own life, assisted by the physician, who would typically give the patient a prescription for a lethal drug; and “voluntary active euthanasia” (VAE), in which the physician, upon request of the patient, would administer a medication or treatment intended to end the patient’s life. In general, the public is closely divided on the former (in the Pew poll, 46 percent favored, 45 percent opposed), while a majority favors VAE.

What is important from a political point of view is that opposition to the removal of Ms. Schiavo’s feeding tube, as well as opposition to PAS, is particularly high among certain voting groups that have a strong voice. Opposition to PAS and VAE is significantly higher among born-again/fundamentalist Protestants, as well as highly religious Catholics and Protestants, than among other Americans, in a pattern similar to attitudes about abortion. The same pattern can be seen in the Schiavo case, where a majority of born-again/evangelical Christians, highly religious Catholics, and those who oppose abortion were against the removal of Schiavo’s feeding tube.

These three groups make up an important part of President Bush’s electoral coalition. In 2004, Bush won 61 percent of the vote of those who attended religious services once a week or more, 74 percent of those who said abortion should be mostly illegal or outlawed completely, and 78 percent of white evangelical Christians. Pro-life voters remain an important voting bloc within the Republican Party, which holds the presidency and both houses of Congress.

As a result, we almost certainly have not seen the end of the right-to-die issue. In fact, the battle may be joined again in the case of Haleigh Poutre, an eleven-year-old girl who suffered a beating and was considered to be in a vegetative state. Because Ms. Poutre is not an adult and (due to a series of events too complex to document here) has no legal parents to speak for her, she is under the custody of the Massachusetts Department of Social Services. The state’s highest court recently ruled that the state could remove her feeding tube. But later reports indicated a possible improvement in her condition, prompting accusations that the state acted too quickly. There are no immediate plans to remove the tube.

In the post-Schiavo climate, it seems doubtful that Congress will try to intervene directly, but the Poutre case is likely to rekindle the debate over end-of-life issues.

John Benson is managing director of the Harvard Opinion Research Program, Harvard School of Public Health, and associate editor of Public Opinion Pros.

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