The Legitimacy of Euthanasia in Europe: Socio Cultural Heritage, Law and Religion As Boundaries of Personal Autonomy in a Multilevel Analysis

In this contribution we analyze the attitudes on the legitimacy of euthanasia (described as “terminating the life of the incurably sick”) as an example of end-of-life issues and assisted dying. We use data from the most recent European Values Study 2008/09. We present results from hierarchical linear random intercept only models (REML estimation) using data from the European Values Study 2008. Within and between country differences (N'=25) will be discussed from a modernization and secularization perspective with a particular and innovative focus on the simultaneous effects of religious and value orientations on both levels of analysis and a focus on both normative and structural determinants extending the analyses of Cohen et al. (2006) and Verbakel and Jaspers (2010).

On the individual level, religious orientations (measured by Siegers’ latent classes; 2012) and self-determination values show substantial but converse effects in the expected directions even when controlling for religious denominations. As compared to atheists (as well as to people with a holistic individualized belief) Muslim believers are most critical of euthanasia; all other Christian denominations also show negative effects. The acceptance of euthanasia is also reduced by higher subjective health, more confidence in the health system and for older respondents.

On the country level, we control for context effects of both postmaterialist value orientations (positive effect) and religious climate (low average church attendance and Protestant countries being most liberal). Furthermore, health systems and patient rights are controlled (no significant effects). Finally, the legal situation concerning end-of-life treatments is strongly reflected in people’s attitudes; and in an extended model (N''=44) the former Communist heritage has a large negative effect even when controlling for all other variables. Overall, institutional and normative criteria are the boundaries of preferences for personal autonomy at the end of life.