Life is more than a survey: understanding attitudes toward euthanasia in Japan.

Empirical studies in bioethics, as well as clinical experience, demonstrate the existence of inter- and intra-cultural diversity in values and perspectives on end-of-life issues. This paper argues that while survey research can describe such diversity, explaining it requires ethnographic methodology that allows ordinary people to frame the discussion in their own terms. This study of attitudes toward euthanasia in Japan found that people face conflicts between deeply held values such as life versus pain, self versus other, and burden versus self-reliance that make it difficult to rely on a "rational person" approach to decision-making. An inductive ethnographic approach grounded in people's life experiences can indicate the reasons for variation in responses to surveys, and can clarify the nature of ethical conflict in a particular cultural setting.