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Laakasuo M, Sundvall J, Francis K, Drosinou M, Hannikainen I, Kunnari A, Palomäki J. Would you exchange your soul for immortality?-existential meaning and afterlife beliefs predict mind upload approval. Front Psychol 2023; 14:1254846. [PMID: 38162973 PMCID: PMC10757642 DOI: 10.3389/fpsyg.2023.1254846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024] Open
Abstract
Mind upload, or the digital copying of an individual brain and mind, could theoretically allow one to "live forever." If such a technology became available, who would be most likely to approve of it or condemn it? Research has shown that fear of death positively predicts the moral approval of hypothetical mind upload technology, while religiosity may have the opposite effect. We build on these findings, drawing also from work on religiosity and existential mattering as predictors of perceived meaning in one's life. In a cross-sectional study (N = 1,007), we show that existential mattering and afterlife beliefs are negatively associated with moral approval of mind upload technology: people who believe there is a soul or some form of afterlife and who also report a high level of existential mattering, are least likely to morally approve of mind upload technology. Indeed, mind uploading-if it ever becomes feasible-is a form of technology that would fundamentally redraw the existential boundaries of what it means to be human.
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Affiliation(s)
- Michael Laakasuo
- Department of Psychology and Logopedics, Faculty of Medicine, Helsinki, Finland
- Faculty of Social Sciences, Department of Social Research, University of Turku, Turku, Finland
| | - Jukka Sundvall
- Department of Digital Humanities, Cognitive Science, Faculty of Arts, University of Helsinki, Helsinki, Finland
| | - Kathryn Francis
- School of Psychology, Keele University, Keele, United Kingdom
| | - Marianna Drosinou
- Department of Psychology and Logopedics, Faculty of Medicine, Helsinki, Finland
| | - Ivar Hannikainen
- School of Psychology, Department of Philosophy, University of Granada, Granada, Spain
| | - Anton Kunnari
- Department of Psychology and Logopedics, Faculty of Medicine, Helsinki, Finland
| | - Jussi Palomäki
- Health and Well-Being Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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Mukhopadhyay S, Banerjee D. Physician assisted suicide in dementia: A critical review of global evidence and considerations from India. Asian J Psychiatr 2021; 64:102802. [PMID: 34388669 DOI: 10.1016/j.ajp.2021.102802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/23/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Dementias are a group of gradually progressing neurodegenerative conditions, leading to significant impairment in cognition, functioning, decision-making, capacity and autonomy. With the rise of human rights and patient-centred perspectives in psychogeriatric management, physician-assisted suicide (PAS) has emerged as an important and integral part of end-of-life care in advanced dementias. METHODS With only few original studies in the area, this paper takes a narrative and critical approach to review the global legislations, treatment decisions, debates as well as perspectives from patients, families and medical professionals. RESULTS PAS and euthanasia are legally allowed in countries like Belgium, Netherlands, Switzerland and few states of the United States (U.S.). Germany has fewer clearer legislations in this regard. The Oregon state requirement and care criteria of the Dutch euthanasia act form the basis of most such laws. Even in the presence of these provisions, PAS is fraught with multiple medical, ethical, moral and legal dilemmas and physicians as well as caregivers are quite heterogenous in their outlook. While right to live with dignity and need to end incurable suffering form the main arguments for PAS, several arguments against it are possibility of undue influence, impaired judgement leading to biased decision-making such as depression and suicidality, inappropriate assessment of capacity, and that all deaths are not necessarily painful. These dilemmas are critically discussed in light of autonomy, decision-making and advanced directives in people living with dementia as well as the rationality of ending life and 'right to live vs right to die'. Based on the findings, certain balanced strategies are highlighted for the health professionals. CONCLUSION The 'slippery slope' of PAS needs to be carefully evaluated from a social justice and human rights perspective to improve dignified end-of-life care in dementia. Considerations are also discussed from India, a rapidly-ageing nation with no current provisions for PAS.
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Affiliation(s)
- Sanchari Mukhopadhyay
- Geriatric Unit and Clinical Services, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Near Dairy Circle, Hosur Road, Bangalore 560029, India
| | - Debanjan Banerjee
- Geriatric Unit and Clinical Services, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Near Dairy Circle, Hosur Road, Bangalore 560029, India.
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Easterly B, Tatalovich R. The people have spoken: Post-materialism and ballot measure voting on physician aid in dying (PAD). DEATH STUDIES 2019; 45:817-826. [PMID: 31809647 DOI: 10.1080/07481187.2019.1696425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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.
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Affiliation(s)
- Bianca Easterly
- Department of Political Science, Lamar University, Beaumont, TX, USA
| | - Raymond Tatalovich
- Department of Political Science, Loyola University Chicago, Chicago, IL, USA
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Augestad LA, Rand-Hendriksen K, Stavem K, Kristiansen IS. Time trade-off and attitudes toward euthanasia: implications of using 'death' as an anchor in health state valuation. Qual Life Res 2012; 22:705-14. [PMID: 22678351 DOI: 10.1007/s11136-012-0192-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE Health state values are by convention anchored to 'perfect health' and 'death.' Attitudes toward death may consequently influence the valuations. We used attitudes toward euthanasia (ATE) as a sub-construct for attitudes toward death. We compared the influence on values elicited with time trade-off (TTO), lead-time TTO (LT-TTO) and visual analogue scale (VAS).Since the 'death' anchor is most explicit in TTO, we hypothesized that TTO values would be most influenced by ATE. METHODS Respondents valued eight EQ-5D health states with VAS, then TTO (n = 328) or LT-TTO (n = 484). We measured ATE on a scale from -2 (fully disagree) to 2 (fully agree) and used multiple linear regressions to predict VAS, TTO, and LT-TTO values by ATE, sex, age, and education. RESULTS A one-point increase on the ATE scale predicted a mean TTO value change of -.113 and LT-TTO change of -.072. Demographic variables, but not ATE, predicted VAS values. CONCLUSIONS TTO appears to measure ATE in addition to preferences for health states. Different ways of incorporating death in the valuation may impact substantially on the resulting values. 'Death' is a metaphysically unknown concept, and implications of attitudes toward death should be investigated further to evaluate the appropriateness of using 'death' as an anchor.
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Affiliation(s)
- Liv A Augestad
- Health Services Research Centre, Akershus University Hospital, 1478, Lørenskog, Norway.
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Kopp SW. The Influence of Death Attitudes and Knowledge of End of Life Options on Attitudes toward Physician-Assisted Suicide. OMEGA-JOURNAL OF DEATH AND DYING 2009; 58:299-311. [DOI: 10.2190/om.58.4.c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
End of life decisions, such as physician-assisted suicide (PAS), have continued to be controversial as health care policy, moral, and individual health care issues. This study considers knowledge of end of life options and death attitudes as predictors of attitudes toward PAS. Data were gathered from approximately 300 adults through a mailing sent to a household research panel. Validated measures of attitudes toward PAS, knowledge about that state's assisted suicide laws, demographics, and attitudes toward death as measured through the Death Attitude Profile-Revised (DAP-R) were collected and analyzed. The data indicate that attitudes toward PAS are a function of knowledge of end of life options as well as death attitudinal factors.
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Mystakidou K, Parpa E, Katsouda E, Galanos A, Vlahos L. The role of physical and psychological symptoms in desire for death: a study of terminally ill cancer patients. Psychooncology 2006; 15:355-60. [PMID: 16184617 DOI: 10.1002/pon.972] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The current study assessed the attitudes of the desire for hastened death in terminally ill cancer patients and whether these are determined by their physical and psychological symptoms. The final sample consisted of 106 terminally ill cancer patients attending a Palliative Care Unit, in University of Athens, Greece, between June and October 2004. Significant associations were found between the desire for hastened death (D.H.D.) and 'pain' (r=0.469, p<0.005), 'fatigue' (r=0.591, p<0.0005), 'loss of appetite' (r=0.622, p<0.0005) and 'feeling sad' (r=0.635, p<0.0005). Statistically significant associations were also found between Schedule of Attitudes towards Hastened Death (SAHD) scores, age (r=0.300, p=0.002) and ECOG (p<0.0005). Twenty-six percent of the patients reported high D.H.D. while 41% reported moderate desire. In the prediction of SHAD the contribution of 'pain' (p=0.011), 'lack of appetite' (p=0.012) and 'sadness' (p=0.011) is high (42% of variance). Further findings suggest that D.H.D. is significantly related to 'feeling sad', 'lack of appetite', 'pain' and 'fatigue' after controlling for age, gender and performance status according to ECOG in terminally ill cancer patients.
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Affiliation(s)
- Kyriaki Mystakidou
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, University of Athens, 27 Korinthias Str., 115 26 Athens, Greece.
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Miller M, Azrael D, Hemenway D. Belief in the inevitability of suicide: results from a national survey. Suicide Life Threat Behav 2006; 36:1-11. [PMID: 16676620 DOI: 10.1521/suli.2006.36.1.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To examine public opinion regarding the effectiveness of means restriction as an approach to preventing suicide we asked a national sample of 2,770 respondents a hypothetical question about what effect a suicide barrier might have had on the ultimate fate of the more than 1,000 people who have jumped to their death from the Golden Gate Bridge. Thirty-four percent of respondents believed that every single jumper would have found another way to complete suicide and an additional 40% believed that "most" would have completed suicide using other means. The strongest predictors of belief in complete substitution were firearm ownership and cigarette smoking. Belief in the inevitability of suicide may be a political impediment to adopting potentially effective suicide prevention efforts.
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Affiliation(s)
- Matthew Miller
- Harvard School of Public Health, Rm. #305 Kresge Building, 677 Huntington Avenue, Boston, MA 02115, USA.
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Pollock JC, Yulis SG. Nationwide newspaper coverage of physician-assisted suicide: a community structure approach. JOURNAL OF HEALTH COMMUNICATION 2004; 9:281-307. [PMID: 15371083 DOI: 10.1080/10810730490468360] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Using a community structure approach linking city characteristics and variations in media coverage, the authors examined newspaper coverage of physician-assisted suicide. A nationwide sample of 15 city newspapers yielded 288 articles in a four year period. Content analysis of article "prominence" (placement, headline size, story length, presence of photos) and overall article direction (favorable, unfavorable, or balanced/neutral) yielded a combined and widely varied single score "Media Vector" or measure of issue "projection" for each newspaper. Correlation and factor analysis yielded two significant city characteristic factors: a "stakeholder" factor, age (percent over 75) associated with unfavorable coverage of physician-assisted suicide (r = -.491; p = 000); and an "access" factor--combining media access (newspaper circulation, cable stations, FM or AM stations) and health care access (health care facilities, physicians)--linked to favorable coverage (r = .472; p = .000), combining to account for 46.3 percent of the variance. Western US newspapers and public opinion are most favorable to physician-assisted suicide.
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Affiliation(s)
- John C Pollock
- Communication Studies Department, The College of New Jersey, Ewing, New Jersey 08642, USA.
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Haider-Markel DP, Joslyn MR. Just how important is the messenger versus the message? The case of framing physician-assisted suicide. DEATH STUDIES 2004; 28:243-262. [PMID: 15053033 DOI: 10.1080/07481180490276571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
As a political issue, death and dying topics only sometimes reach the political agenda. However, some issues, such as physician-assisted suicide (PAS) have been highly salient. This article explores attitudes toward PAS by examining the malleability of opinion when respondents are exposed to issue frames and when specific messengers present those frames. We used 4 experimental conditions in a statewide survey and 1 control group, which allowed us to compare the impact of a framed message on opinion as well as that message presented by a specific messenger. Results suggest that support for PAS can be shaped by whether PAS is framed as individual choice or as a matter involving sanctity of life. In addition, we find that specific messengers did not influence opinion on PAS beyond the influence of the issue frame itself, controlling for respondent characteristics such as gender and race. Indeed, the findings indicate that messengers may in fact reduce the intended impact of issue frames of opinion toward PAS.
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Ziegler SJ, Jackson RA. Who's not afraid of Proposal B? An analysis of exit-poll data from Michigan's vote on physician-assisted suicide. Politics Life Sci 2004; 23:42-8. [PMID: 16859379 DOI: 10.2990/1471-5457(2004)23[42:wnaopb]2.0.co;2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
In November 1998, Michigan voters rejected Proposal B, a citizen initiative that would have legalized physician-assisted suicide (PAS). Although polls had long indicated overwhelming support for PAS, support for Proposal B declined before the election. We analyzed exit-poll data to characterize opponents, supporters, and cross-over voters. We then compared our results with those from earlier research that examined attitudinal and socio-demographic influences. We found that many presumptive PAS supporters did not vote for Proposal B. These data may call into question prospects for similar initiatives.
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Affiliation(s)
- Stephen J Ziegler
- School of Public and Environmental Affairs, Indiana University - Purdue University, Neff Hall 260E, 2101 East Coliseum Boulevard, Fort Wayne, IN 46805-1499, USA.
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