The aim of the study is to explore how various medical symptoms influence perceived justifiability of euthanasia. **Procedure** In the main part of the study, we will ask participants on Amazon Mechanical Turk (N = 500, payment = $0.38) about their perception of justifiability of euthanasia in a hypothetical case where a terminally ill patient suffers from a certain untreatable symptom. Participants will be provided a list of symptoms and for each of them answer how justifiable euthanasia is in the case that the patient’s symptom is the given symptom. Before rating justifiability of euthanasia, we will ask participants to complete a personality and demographic survey consisting of question about their moral foundations, religiosity, political orientation, education, gender and orientation to happiness. Finally, participants will answer whether they consider that people should have the right for euthanasia in a range of different situations. The full wording of the materials is provided below. In the second part of the study, we will ask participants on Amazon Mechanical Turk (N = 600, payment = $0.24) to rate the symptoms form the first part based on a degree in which they cause consequences such as “physical suffering”, “loss of dignity” and others. See below for the full list of rated dimensions. Each participant will rate all symptoms on only one dimension. **Analysis** The list of symptoms includes two “symptoms” used to check participants’ careful reading and attention (“select option one” and “select option eight”). We will exclude data from the participants who will fail to answer any of these attention checks correctly. We will also exclude participants who completed the whole study in less than 2 minutes. Most of the analyses we will perform will be exploratory. Some hypotheses that we will test include: Perceived justifiability of euthanasia differs between symptoms. Some aspects (rated in the second part of the study) may better predict perceived justifiability of euthanasia than others (justifiability of euthanasia may be, for example, predicted by physical suffering associated with the symptom, but not by some other dimension). The aspects reported to be a reason to have the right for euthanasia will predict which symptoms will participants perceive as a justifiable cause for euthanasia. That is, the ratings of justifiability of euthanasia for symptoms rated highly in certain domain will be associated with participants’ answers about the right for euthanasia for the corresponding reason. Religiousness, education, moral foundations, orientation to happiness, and political orientation will be associated with general acceptance of euthanasia (computed as the mean rating across all symptoms) and also specifically with justifiability of euthanasia associated with symptoms rated highly in certain domains. For example, the belief that “Life has a lasting meaning.” may correlate with overall condemnation of euthanasia but even more strongly for condemnation of euthanasia associated with reasons related to the loss of identity and change of personality. <br> **Materials** INTRODUCTION The following study concerns moral judgment. First you will answer a series of questions about personality and demographics. Please carefully read and answer all questions. MORAL FOUNDATIONS When you decide whether something is right or wrong, to what extent are the following considerations relevant to your thinking? Whether or not someone suffered emotionally Whether or not some people were treated differently than others Whether or not someone’s action showed love for his or her country Whether or not someone showed a lack of respect for authority Whether or not someone violated standards of purity and decency Whether or not someone cared for someone weak or vulnerable Whether or not someone acted unfairly Whether or not someone did something to betray his or her group Whether or not someone conformed to the traditions of society Whether or not someone did something disgusting Whether or not private property was respected Whether or not everyone was free to do as they wanted *scale:* not at all relevant not very relevant slightly relevant somewhat relevant very relevant extremely relevant <br> ORIENTATION TO HAPPINESS To what degree do you agree with the following statements? Life has a lasting meaning. The good life is the pleasurable life. 1 – completely disagree - 7 – completely agree <br> RELIGIOUSNESS How religious are you? 1 – not at all religious - 7 – very religious <br> GENDER What is your gender? male female other prefer not to say <br> EDUCATION What is the highest level of education that you have completed? Did Not Complete High School High School/GED Some College, no degree Bachelor's Degree Master's Degree Advanced Graduate work or Ph.D. <br> POLITICAL ORIENTATION Regarding **economic issues**, where would you place yourself on the scale arranged from extremely liberal to extremely conservative? Regarding **social issues**, where would you place yourself on the scale arranged from extremely liberal to extremely conservative? 1 – extremely liberal - 7 – extremely conservative <br> SCENARIO Imagine that there is **a terminally ill patient** who will die approximately in a year. The patient expresses repeatedly **a wish to die and asks doctors for euthanasia**. Apart from ultimately leading to death, **the illness is associated with an untreatable symptom**. Please rate **how morally justifiable would euthanasia be** if the symptom was: 1 – not at all justifiable - 8 – completely justifiable LIST OF SYMPTOMS (randomized order) severe loss of past autobiographical memories inability to remember new information mild intermittent pain moderate intermittent pain severe intermittent pain mild chronic pain moderate chronic pain severe chronic pain chronic confusion / persistent delirium visual hallucinations auditory hallucinations paranoia apathy (indifference towards surroundings) inability to feel emotions severe depression chronic fatigue severe difficulty sleeping frequent nightmares hopelessness suicidal thoughts muteness blindness deafness coprolalia (involuntary swearing) pathological lying cruelty aggressiveness homicidal thoughts antisocial behavior loss of empathy intense mood swings pedophilia homosexuality zoophilia inability to focus and concentrate loss of language understanding moderately impaired intelligence severely impaired intelligence fecal incontinence urinary incontinence persistent nausea with daily vomiting severe facial deformity skin lesioning paraplegia (loss of function of legs) quadriplegia (total loss of function of limbs) difficulty breathing and swallowing complete paralysis of all voluntary muscles except for the eyes muscle weakness impotence <br> RIGHT FOR EUTHANASIA Please indicate to what degree do you agree that: **Everybody should have the right for euthanasia …** … if they are physically suffering. … if they are psychologically suffering. … if they lost their dignity. … if they lost their personal identity. … if their personality changed negatively. … if they have a low quality of life. … if they lost their self-reliance. … if they wish so. … if they are tired of living. … if they are a burden on others. 1 – strongly disagree - 7 – strongly agree <br> SYMPTOM RATINGS (different participants) Ill patients can experience a range of medical symptoms. To what degree do you believe that the following symptoms are associated with ... (Please try to use the whole range of the scale.) patient’s physical suffering patient’s psychological suffering patient’s loss of dignity patient’s loss of personal identity patient’s negative change of personality patient’s decreased quality of life patient’s loss of self-reliance the patient being a burden on others 1 – not at all associated - 7 – strongly associated