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| Do you understand what assisted suicide is? |
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| Do you think assisted suicide should exist in general? |
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| Should people be in control of the time of their death? |
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| Should people be in control of their manner of death? |
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| Do you believe assisted suicide should be permitted for medical reasons? |
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| If you answered yes to #5, should there be medical requirements (Ex: having a prognosis of limited time left to live) to apply for assisted suicide? If not, select N/A. |
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| Do you believe assisted suicide should be permitted for social reasons? |
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| If you answered yes to #7, should there be social requirements (Ex: sufferings, depression, or bullying) for assisted suicide? If not, select N/A. |
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| Do you believe assisted suicide should be permitted for economic reasons? |
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| Is there an economic benefit to assisted suicide? |
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