Exploring the public attitudes toward euthanasia legalization in China, especially among individuals with mental...

The legalization of euthanasia remains a highly contentious issue in China, with no comprehensive cross-sectional studies conducted in the country to date. However, in end-of-life decision-making among terminally ill patients, psychosocial factors demonstrate significantly greater predictive power than somatic determinants.

A national cross-sectional study based on multistage random sampling was conducted from June 20 to August 31, 2022, in China. We employed a stratified random sampling method, collecting a total of 31,449 questionnaires of Chinese residents aged above 18. We employed a multivariate ordinal logistic regression model, considering various factors. Additionally, we conducted subgroup analyses to address potential confounding factors and fitted the same model to obtain the corresponding coefficients, odds ratios, 95% confidence intervals, and P-values, which were used to assess the results.

Several factors were found to influence the attitude of euthanasia legalization in China. Lower age, higher educational level, and higher family monthly income showed positive attitudes toward euthanasia legalization. Comparative analysis revealed that females were more likely to support euthanasia legalization than males. Moreover, adherents of Buddhism or Islam demonstrated significantly lower support for euthanasia legalization compared to non-affiliated respondents. Individuals majored in medicine were more likely to support euthanasia legalization than other academic disciplines. Notably, individuals living with mental disorders or other chronic diseases showed a greater tendency to support euthanasia legalization. Compared to individuals who did not encounter any serious events, those who had experienced the death of a close relative had higher scores supporting euthanasia legalization.

Basic demographic information, economic status, physical health status and lived experience are associated with attitudes toward euthanasia legalization. This study can contribute towards promoting more holistic and balanced legislation and policy implementation on euthanasia, reconciling considerations of individual autonomy, medical ethics, and broader societal interests.

Not applicable.