What Determines End-of-Life Attitudes? Revisiting the Dutch Experience

Societal attitudes and behaviours of suicide and euthanasia often cannot be compared leaving policy makers without informative understanding of how social indicators such as social norms, attitudes, behaviours, identity and culture shape the relationships held to socio-demographic indicators of pro end-of-life attitudes. Applying social indicator principals from behavioural economic theory, we assess attitudes to suicide and euthanasia using the Netherlands as a quasi-experiment. We analysed data extracted from the European Values Study (EVS) from 1981 to 2008 in the Netherlands. This timeframe encompasses the Supreme Court ruling: ‘The Right to Die—1984’ and the ‘Termination of Life on Request and Assisted Suicide (Review Procedures) Act of 2002’. Adopting a pooled ordered logit cross-sectional analysis, we assessed indicators of attitude change towards suicide and euthanasia as a quasi-experimental difference-in-differences estimation across socio-demographic indicators through 1981–1990 and 1999–2008. We find through these periods, only employment status and religiosity remain consistent and significant indicators for suicide. Whereas age, employment status, marital status and having a religious denomination remain consistent and significant indicators for euthanasia throughout both periods. Our findings provide a revised socio-demographic indicator model and extend psycho-social indicator factors from behavioural economics to approach research of end-of-life attitudes of suicide and euthanasia.