Surveys on attitudes towards legalisation of euthanasia: importance of question phrasing

Aim: To explore whether the phrasing of the questions and the response alternatives would influence the answers to questions about legalisation of euthanasia. Methods: Results were compared from two different surveys in populations with similar characteristics. The alternatives "positive'', "negative'', and "don't know'' (first questionnaire) were replaced with an explanatory text, "no legal sanction'', four types of legal sanctions, and no possibility to answer "don't know'' (second questionnaire). Four undergraduate student groups (engineering, law, medicine, and nursing) answered. Results: In the first questionnaire (n = 684) 43% accepted euthanasia (range 28-50%), 14% (8-33%) did not, and 43% (39-59%) answered "don't know''. Two per cent of the respondents declined to answer. In comparison with previous surveys on attitudes to euthanasia the proportion of "don't know'' was large. The results of the second questionnaire (n = 639), showed that 38% favoured "no legal prosecution'' (26-50%). However, 62% (50-74%) opted for different kinds of legal sanctions, and two of four groups expressed significantly different views in the two surveys. A proportion of 10% declined to answer the second questionnaire. Conclusion: An introduction of an explanatory text and a wider range of response alternatives produced differences between the results of the two surveys conducted.