Survey: The Right to Die

1. Do you favor or oppose making it legal (as it is in Oregon) for doctors to give terminally ill patients the means to end their lives?

Favor

Oppose

2. Upon which of the following do you believe the choice to end one’s life should be based:

The individual's wishes

The laws of the government

The laws of the church

Some other third party

3. If you were in a persistent vegetative state, where your mental functioning had ceased, and where it was highly unlikely you would ever regain consciousness, what would you want?

Be kept alive by artificial means

Have artificial means removed

4. If you were terminally ill with no perceived hope of recovery, would you want a doctor to give you the means to end your own life?

Yes

No

5. If you are suffering at the end of life and your doctor cannot relieve that suffering, would you want the option of being sedated into unconsciousness, even though this might hasten your death?

Yes

No

6. Do you currently have a legal document (i.e., advance health care directive) or formal instructions in place that specify what your wishes are if there is no hope for your recovery and you are unable to speak for yourself?

Yes

No

Not sure

7. (If you answered “NO” to #6) Are you planning to have such a document in place sometime soon or when you are older?

Yes

No

8. Do you have parents, close relatives or friends who are in their senior years for whom you might be, or eventually be, considered a guardian, caretaker or legal trustee?

Yes

No

Not sure

9. (If you answered “YES” to Q8) Have you discussed with them their wishes of what you should do if they were terminally ill with no perceived hope of recovery or in a persistent vegetative state?

Yes

No

Not sure

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