Factors Associated with the Choice of Euthanasia in End-of-life Care: An Interpersonal Theory of Suicide Perspective

Abstract

With advances in modern medicine, life expectancy has increased, drawing greater attention to the choices surrounding life and death in end-of-life care. According to the Interpersonal Theory of Suicide, individuals may choose death when they feel they are a burden to others (Perceived Burdensomeness: PB), feel socially disconnected (Thwarted Belongingness: TB), or no longer fear death (Capability for Suicide: CS). Based on this theory, the present study examined factors associated with the choice of euthanasia as a form of rational suicide. Online survey data from 540 Japanese adults collected in March 2025 indicated that both PB and CS were positively and significantly associated with willingness to choose euthanasia, whereas TB showed no significant association.