Although research consistently shows that both individual and national religiosity are negatively associated with the justification of euthanasia, there is a lack of knowledge about the moderators of this relationship. Beliefs in life after death provide a framework for attributing meaning beyond earthly existence. Using data from the most recent wave of the European Values Study project (EVS, 2022), this study examined how such beliefs in life after death relate to the justification of euthanasia and moderate the religiosity-euthanasia relationship at both individual and cultural levels in a cross-national context. A multilevel analysis of 35 countries and approximately 48,000 participants revealed that both religiosity and beliefs in life after death significantly increased opposition to euthanasia. Moreover, beliefs in life after death strengthened the negative association between religiosity and the justification of euthanasia. Findings suggest that these beliefs in life after death operate simultaneously at the individual and cultural levels. These results highlight the importance of multilevel approaches to understanding end-of-life attitudes and underscore the need for public health policies to consider cultural beliefs about death when addressing euthanasia legislation and clinical decision-making.

This work was supported by the Portuguese Foundation for Science and Technology [grant numbers 2023.04877.BD, UIDB/03126/2020].

Euthanasia,Assisted death,End-of-life attitudes,Religiosity,Beliefs in life after death,Multilevel moderation,European values study

This publication is an output of the following project(s):

• Aversion2agony: Uma análise comparativa transnacional da mediação jornalística da eutanásia em Portugal e no Reino Unido
• Candidates Survey (MPs and non-elected candidates) for the 2019 Legislative Elections
• Candidates Survey (MPs and non-elected candidates) for the 2022 Legislative Elections
• Candidates Survey (MPs and non-elected candidates) for the 2024 Legislative Elections