Psychosocial predictors of support by older adults for euthanasia and physician-assisted suicide (EPAS)

Ending one's life through active euthanasia or physician-assisted suicide (EPAS) is a contentious topic, especially for older adults for whom the issue is not hypothetical. Existing research suggests that attitudes toward EPAS are influenced by health, sociodemographic (eg, age, religiosity), and psychological factors (eg, perceived control). Attitudes vary widely across societies. For this cross-sectional study, 466 older Israeli adults living independently in the community (mean age, 82.35 years; range, 65-101) completed a questionnaire battery assessing fear of death, fear of dying, and will to live. Participants also reported their perceived health. Path analysis showed that support for EPAS was predicted by fear of dying and inversely predicted by both religiosity and will to live. Indirect predictors of EPAS included age (via will to live and religiosity), perceived control (via fear of dying), and perceived health (via will to live and perceived control). The path model explained 32% of the variance in support for EPAS (R² = 0.32, P < .01). Notably, age predicted support for EPAS only indirectly and bidirectionally: older age was linked to greater support for EPAS via lower will to live, and to lower support via greater religiosity. There was no direct association between age and support for EPAS, and indirect effects largely negated each other.