Latvian Population Attitudes Towards Euthanasia and Physician-Assisted Suicide: A Cross-Sectional Pilot Survey

Euthanasia and physician-assisted suicide remain among the most contested issues in contemporary medical ethics. In Latvia, no form of euthanasia is currently legal, yet public debate periodically resurfaces, while empirical data on population attitudes are scarce. This cross-sectional pilot study evaluated knowledge, attitudes and personal experience related to euthanasia and assisted dying among Latvian residents. An anonymous online questionnaire (Google Forms) comprising demographic, knowledge, Likert-scale, scenario-based and open-ended items was distributed via convenience and snowball sampling. Of 485 respondents, 98.1% consented; the sample was predominantly female (85.2%), highly educated (76.1% with higher education) and aged 30-64 (77.5%). Awareness of euthanasia was high (97.3%), whereas only 46.6% felt adequately informed about palliative care. Support for legalization in the future reached 85.6%, and support was highest for passive euthanasia (84.5%) and oncology-related euthanasia (85.2%), lower for physician-assisted suicide (65.8%) and lowest for severe dementia (44.5%). Religious affiliation was the strongest differentiating factor: non-religious respondents supported legalization far more than Christians (94.2% vs 77.2%), whereas education, sex and region showed only modest differences. The most frequently required safeguards were unbearable persistent suffering (88.0%) and incurable disease (73.8%). Findings indicate strong public openness to regulated assisted dying alongside a pronounced palliative-care information gap. Results are exploratory given the non-representative sample.

Cohen, J., Marcoux, I., Bilsen, J., Deboosere, P., van der Wal, G., & Deliens, L. (2006). Trends in acceptance of euthanasia among the general public in 12 European countries (1981-1999). European Journal of Public Health, 16(6), 663-669.

Emanuel, E. J., Onwuteaka-Philipsen, B. D., Urwin, J. W., & Cohen, J. (2016). Attitudes and practices of euthanasia and physician-assisted suicide in the United States, Canada, and Europe. JAMA, 316(1), 79-90.

Health Canada. (2025). Sixth annual report on medical assistance in dying in Canada. Ottawa: Health Canada. Retrieved from https://www.canada.ca/en/health-canada/services/publications/health-system-services/annual-report-medical-assistance-dying-2024.html

Materstvedt, L. J., Clark, D., Ellershaw, J., Førde, R., Gravgaard, A. M., Müller-Busch, H. C., ... EAPC Ethics Task Force. (2003). Euthanasia and physician-assisted suicide: A view from an EAPC Ethics Task Force. Palliative Medicine, 17(2), 97-101.

Rietjens, J. A. C., van Tol, D. G., Schermer, M., & van der Heide, A. (2009). Judgement of suffering in the case of a euthanasia request in the Netherlands. Journal of Medical Ethics, 35(8), 502-507.

RTE. (2024). Annual report 2024. The Hague: Regional Euthanasia Review Committees. Retrieved from https://www.euthanasiecommissie.nl/