The respondent must be assured that all replies are anonymous, strictly confidential and that the results are for educational purposes only. Age: Nationality: Gender: Male/female Please circle your choice
1. Do you have ever heard about euthanasia? Yes / No 2. How are you think about euthanasia?
a) Humane b) Cruel c) I don’t know any about it 3. Do you think euthanasia should be legal? Yes / No 4. Do you think doctors have rights to judge patients can be used euthanasia? Yes / No 5. Do you think euthanasia protect patients’ dignity? Yes / No 6. Do you believe patients have rights to put forward ending their lives? Yes /No 7. Do you agree that patients family have rights to put forward ending patients’ lives when patients are unable to move or talk and suffering in huge pain? Yes / No If it’s not, do you suggest that family should make every effort to keep treating? (even the treatment will make patients feel in huge pain) Yes / No 8. Which kind of euthanasia you will more easier to accept? a) Ending treatment to let patients die naturally
b) Injection medicine to let patients die with no pain 9. If one of your family was sick and will die in 3 months, besides she or he is suffering in huge pain. He or she puts forward to use euthanasia ending his or her own life. Are you willing to support him or her? If you choose yes, why?
If you choose no, why?