Physician-assisted suicide in the States : public opinion, public policy and direct democracy

This research examines the relationships between public opinion, direct democratic elections and physician-assisted suicide policy in the states. Despite public opinion polls that report popular support for the legalization of physician-assisted suicide, most states have criminalized the practice. In response, citizen groups have initiated ballot proposals to legalize physician-assisted suicide in California, Washington, Oregon and Michigan. Of these four campaigns, Oregon and Michigan provide the best examples of opposite outcomes. In spite of high public support of physician-assisted suicide, the initiative narrowly passed in Oregon and was overwhelmingly rejected in Michigan.

Therefore, this research has analyzed the two campaigns to legalize physician assisted suicide to determine what factors affected the outcome of the initiative elections. Using the campaign in Oregon as a point of comparison, this research answered the question: What factors contributed to the defeat of the initiative to legalize physician assisted suicide in Michigan? In answering this question, four aspects of the campaigns were analyzed in depth: the organizations (campaign fundraising and campaign advertising); the mass media (news editorials and news coverage); the initiatives (initiative length, ballot placement and initiative complexity) and the state electorates.

This research concluded that a combination of all four aspects of the campaigns affected their outcomes, as opposed to identifying one specific cause for the failure of the Michigan Proposal or the passage of the Oregon Measure. Specifically, seven factors were identified as most influential on the outcomes: campaign spending, campaign advertising, news editorials, news coverage, ballot length, ballot complexity and state electorates.

The factors most likely to have contributed to the defeat of the ballot proposal in Michigan are the following;

(1) The outspending by opponents to Proposal B.

(2) The overwhelming amount of opposition advertising, which aired without counter advertisements by supporters of Proposal B.

(3) All newspaper editorials in opposition to Proposal B.

(4) The higher percentage of news coverage of opponents to Proposal B compared to the supporters of the Proposal, and the higher percentage of horserace coverage on Proposal B.

(5) The excessive length of the ballot Proposal in Michigan.

(6) The high reading level required for comprehension of the Proposal in Michigan.

(7) The larger percentage of blacks and regular weekly church attendees, in Michigan: the two groups most opposed to physician-assisted suicide.