The people have spoken: Post-materialism and ballot measure voting on physician aid in dying (PAD)

Abstract

For decades, public opinion polls have shown that most Americans favor physician aid in dying (PAD) but little is known about those who support PAD ballot measures. With its emphasis on self-fulfillment, personal choice, and civic and political engagement, post-materialists would argue that adopting states tend to have younger, educated, and more secular populations. County-level votes on all nine ballot measures to legalize death with dignity were subjected to multiple regression analysis. The results largely confirm the hypotheses derived from post-materialist theory, namely that education, religion, and more problematically age significant indicators of PAD ballot measure voting.

Notes

1 There are number of terms used to describe the act of hastening death (e.g., euthanasia, physician assisted suicide (PAS)) but the medical associations in California, Colorado, Hawaii, Maine, Maryland, Massachusetts, Nevada, Oregon, Washington, Washington, D.C., as well as numerous national organizations including the American Public Health Association, American Academy of Hospice and Palliative Medicine, American College of Legal Medicine and American Association of Suicidology intentionally use value-neutral language such as aid in dying, death with dignity, and physician-assisted death (see Death with Dignity (n.d.). Terminology of assisted dying. Retrieved from https://www.deathwithdignity.org/terminology/).

2 Similar laws also exist in Belgium, Canada, Columbia, Luxembourg, the Netherlands, and Switzerland (Emanuel, Onwuteaka-Philipsen, Urwin, & Cohen, 2016)

3 The Montana Supreme Court decision decided in Baxter v. Montana (2009) that its constitution does not prohibit aid in death but falls short of legalizing it. In the decision, the state supreme court ruled on narrow grounds that there is “nothing in Montana Supreme Court precedent or Montana statutes indicating that physician aid in dying is against public policy.” The high court, however, did not rule on the constitutionality of PAD. In its aftermath, bills from both proponents and opponents of PAD were introduced into the Montana State Legislature during the 2011, 2013, 2015, and 2017 legislative sessions but none were enacted.

4 Ballotpedia (n.d). Initiative and referendum. Retrieved from https://ballotpedia.org/Initiative_and_referendum

5 Hemlock Society launched its first ballot initiative measure in its home state of California in 1988 through its organization, Americans Against Humane Suffering (AAHS). “The Human and Dignified Death Act” failed to get the necessary number of signatures to qualify for the ballot.

6 Death with Dignity (n.d.). How death with dignity laws work. Retrieved from https://www.deathwithdignity.org/learn/access/

7 We coded 2010 for CO 2016, MA 2012 and WA 2008; 2000 for ME 2000, MI 1998, and OR 1997; and 1990 for WA 1991, CA 1992, and OR 1994.

8 Broomfield County, Colorado was not established until 2001. Since Broomfield County was carved out of four existing counties (Adams, Boulder, Jefferson, and Weld), for purposes of this analysis we assigned to Broomfield County the average value in the 2000 U.S. Census of those four counties with respect to median age, median household income, population density, and percent with a B.A. degree as well as average percent Democratic presidential vote in 1996 and 2000 in order to calculate the average Democratic presidential vote over the 1996–2000–2004 elections.

9 Ballotpedia (n.d). Colorado end of life options act, proposition 106 (2016). Retrieved from https://ballotpedia.org/Colorado_End_of_Life_Options_Act,_Proposition_106_(2016).