An Examination of State-Level Personality Variation and Physician Aid in Dying Legislation

J Pain Symptom Manage. 2018 Sep;56(3):385-389. doi: 10.1016/j.jpainsymman.2018.05.023. Epub 2018 Jun 6.


Context: Physician aid in dying is a controversial topic in the U.S., and legislation exists in some states. Personality traits are associated with preferences for end-of-life care and also tend to cluster systematically across states and other geographic regions. Such clustering of personality traits could relate to legislation including physician aid in dying.

Objective: To determine whether average levels of personality traits in each U.S. state differ between states with and without physician aid in dying legislation.

Methods: This secondary analysis of national surveys included data on state demographics, political leanings, and state-level averages of Five-Factor Model personality traits. Wilcoxon tests and logistic regression tests were used to assess whether state-level averages in personality traits differed across states with and without physician aid in dying legislation.

Results: States with physician aid in dying legislation had significantly higher average levels of the trait of openness and significantly lower average levels of the trait of neuroticism. The association with openness was no longer significant after accounting for state conservative advantage.

Conclusion: The social dialogue and potential controversy surrounding physician aid in dying may be linked to aggregate differences in state personality profiles. States with physician aid in dying legislation tend to be areas where constituents are on average more open minded and experience greater emotional stability. More work is needed to ascertain whether the experiences of receiving and providing end-of-life care may differ across these regions, particularly in relation to conversations around physician aid in dying.

Keywords: Personality; end-of-life care; hastening death; legislation; physician aid in dying.

MeSH terms

  • Adult
  • Attitude to Death
  • Attitude to Health
  • Female
  • Humans
  • Male
  • Personality*
  • Suicide, Assisted / legislation & jurisprudence*
  • Suicide, Assisted / psychology*
  • United States