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Exit Survey
 
 
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Are you familiar with the Death With Dignity Act ?
Yes Somewhat Not at All
Overall
 
 
Would you like to see more options for adults in Illinois that are facing end of life consequences ?
Very Interested Somewhat Interested Neutral Not Interested
Overall
 
 
Would you like more information pertaining to the Death With Dignity Act ?
Very Interested Somewhat Interested Neutral Not Interested
Overall
 
 
Do you agree that adults should have the legal right to Physician Assisted Suicide in Illinois ?
Strongly Agree Agree Neutral Disagree Strongly Disagree
Overall
 
 
 
Are you aware that Oregon, Montana, Washington, and Vermont passed laws that provide options of physician assisted suicide to terminally ill adults ?
 
Yes
 
No
 
 
Imagine that you are suffering from a disease that is terminal, debilitating, and very painful. Should you have the right to die when you wish, rather than live in continued agony?
Strongly Agree Agree Neutral Disagree Strongly Disagree
Overall
 
 
If you had a terminal illness would you want to live in a state that offered the opportunity to discuss options with your physician regarding physician assisted dying with dignity ?
Strongly Agree Agree Neutral Disagree Strongly Disagree
Overall
 
 
If you lived in a state that offered physician assisted suicide and met the legal criteria for this option, would you ever consider this as an end of life decision for yourself ?
Strongly Agree Agree Neutral Disagree Strongly Disagree
Overall
 
 
Do you believe physician assisted suicide is ever justified ?
Strongly Agree Agree Neutral Disagree Strongly Disagree
Overall
 
 
Please select which political party you identify with.
Democratic Republican Libertarian No Preference
 
 
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