ing death anxiety or denial. However, despite characterizations of the United States as a "death-denying society," direct evidence for this thesis is "remarkably sparse" (Neimeyer and van Brunt, 1995, p. 52). Moreover, some evidence suggests that education aimed at altering attitudes may sometimes arouse death anxiety rather than dampen it (McClam, 1980; Testa, 1981; Rigdon and Epting, 1985; Durlak and Riesenberg, 1991; Durlak, 1994).

Public opinion research has tended to focus on specific issues such as attitudes about assisted suicide, hospice, or advance directives. Since 1977, 13 surveys conducted by the National Opinion Research Center (NORC) have asked whether doctors should be legally allowed to painlessly end a patient's life if the patient and family request it. During this period, the percentage of respondents agreeing has risen from approximately 60 percent to about 70 percent. The 1996 poll showed that support was highest among younger people (over 75 percent in the 18 to 34 age group) and lowest among older people (about 60 percent in those age 65 and over). On the issue of whether a person has the right to end his or her own life (in an unspecified fashion) because of incurable illness, NORC surveys report a shift from majority disagreement in the 1970s and early 1980s to majority agreement in recent years (64 percent in 1996).

The NORC findings are generally consistent with other research (Harvard School of Public Health/Boston Globe Poll, 1991; Blendon et al., 1992; Foreman, 1996). A Gallup Poll taken in late summer 1996, however, reported that only 50 percent of those surveyed believed physician-assisted suicide should be legal (NHO, 1996b). This compared to 75 percent of those in an April 1996 Gallup Poll who responded positively to a question that was similar to the NORC question in not using the term suicide (Foreman, 1996). The late summer survey showed that women were less likely to believe that physician-assisted suicide should be legal and less likely to predict that they would avail themselves of that option should they become terminally ill.

Patient preferences regarding end-of-life care have been a particular interest of researchers, clinicians, and policymakers as reflected in the considerable literature on advance directives and similar measures, which is discussed in Chapter 3. When questioned about who people would want to make final choices about their care if they were seriously ill, a 1994 Louis Harris Poll reported that 67 percent of the national sample said that they wanted to make the decisions, but 28 percent wanted their doctor to decide (Medica Foundation, 1994).

Two Gallup Polls, one in 1992 and another in 1996, found 9 out of 10 respondents reporting that they would prefer to be cared for at home if they were terminally ill with six months or less to live (Seidlitz et al., 1995; Foreman, 1996; NHO, 1996b). These results are consistent with smaller studies (Townsend et al., 1990; McCormick et al., 1991). Although a ma-

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