Predictors of Support for Euthanasia and Physician-Assisted Suicide (EPAS) Among Older Adults in Israel

Euthanasia and physician-assisted suicide (EPAS) are highly contentious topics with significant medical, legal, and cultural implications. Previous research suggests that various sociodemographic, health, and psychosocial factors determine attitudes toward EPAS. This study set out to identify psychosocial predictors of support for EPAS. We hypothesized that perceived control, self-efficacy, and social support would each predict support for EPAS after controlling for sociodemographic and health-related variables.

For this study, we recruited 446 Jewish Israeli adults who were 82.32 years of age on average (SD = 5.99; range 65-101 years). Participants completed a battery of questionnaires including a series of vignettes featuring hypothetical family members with a terminal illness (i.e., cancer, dementia, Parkinson's disease). We performed a three-step hierarchical regression equation, controlling for demographic factors (age, gender, education, relationship status, economic status, and religiosity) as well as perceived and relative physical health.

As hypothesized, both self-efficacy and (the absence of) social support predicted support for EPAS; perceived control did not. Religiosity was the strongest predictor of opposition to EPAS. Fully 31% of variance in support for EPAS was predicted by this regression model.

Support for EPAS does not appear to reflect a pervasive need for control over all aspects of life (i.e., perceived control) but a more specific need for personal autonomy (i.e., self-efficacy). Longitudinal research is required over multiple points of data collection to ascertain how change in social support affects support for EPAS in late life. Policy makers should embrace these findings when formulating end-of-life care policies, ensuring that both social support and personal autonomy are prioritized in the care of older adults.