Encyclopedia of Sociology Vol

Percent of Completed Suicides in 1987 and 1992 by Method and Gender

Table 4

NOTE: *Includes gases in domestic use (E951), other specified and unspecified gases and vapors (E952.8–952.9), explosives (E955.5), unspecified firearms and explosives (E955.9), and other specified or unspecified means of hanging, strangulation, or suffocation (E953.8–953.9).

SOURCE: Data from National Center for Health Statistics, 1995.

Phillips’s ideas about contagion dominated the sociological study of suicide in the 1980s. Works by Stack (1982), Wasserman (1989), Kessler and Strip (1984), and others have produced equivocal support for the role of suggestion in suicide (Diekstra et al. 1989). Wasserman (1989) feels that the business cycle and unemployment rates must be controlled for. Some have claimed that imitative effects are statistical artifacts. Most problematic is the fact that the theory of imitation in suicide is underdeveloped.

The most recent sociologist to study suicide is the medical sociologist Pescosolido. She has claimed, contrary to Douglas, that the official statistics on suicide are acceptably reliable and, as Gibbs said earlier, are the best basis available for a science of suicide. Her latest paper (Pescosolido and Georgianna 1989) examined Durkheim’s claim that religious involvement protects against suicide. Pescosolido and Georgianna find that Roman Catholicism and evangelical Protestantism protect one against sui-

Common Single Predictors of Suicide

1.Depressive illness, mental disorder

2.Alcoholism, drug abuse

3.Suicide ideation, talk, preparation, religion

4.Prior suicide attempts

5.Lethal methods

6.Isolation, living alone, loss of support

7.Hopelessness, cognitive rigidity

8.Older white males

9.Modeling, suicide in the family, genetics 10. Work problems, economics, occupation 11. Marital problems, family pathology

12. Stress, life events

13.Anger, aggression, irritability, 5-HIAA

14.Physical illness

15.Repetition and comorbidity of factors 1–14, suicidal careers

Table 5

SOURCE: Maris et al. 1992, chap. 1.

cide (institutional Protestantism does not) and that Judaism has a small and inconsistent protective effect. Those authors conclude that with disintegrating network ties, individuals who lack both integrative and regulative supports commit suicide more often.

ISSUES AND FUTURE DIRECTIONS

Much of current sociological research on suicide appears myopic and sterile compared to the early work of Durkheim, Douglas, and Garfinkel. Not only is the scope of current research limited, there is very little theory and few book-length publications. Almost no research mongraphs on the sociology of suicide were written in the 1980s. Highly focused scientific journal articles on imitation have predominated, but none of these papers have been able to establish whether suicides ever were exposed to the original media stimulus. Since suicide does not concern only social relations, the study of suicide needs more interdisciplinary syntheses. The dependent variable (suicide) must include comparisons with other types of death and

violence as well as more nonsocial predictor variables (Holinger 1987).

A second issue concerns methods for studying suicide (Lann et al. 1989). There has never been a truly national sample survey of suicidal behaviors in the United States. Also, most suicide research is retrospective and based on questionable vital statistics. More prospective or longitudinal research design are needed, with adequate sample sizes and comparison or control groups. Models of suicidal careers should be analyzed with specific and appropriate statistical techniques such as logistic regression, log-linear procedures, and event or hazard analysis. Federal funds to do major research on suicide are in short supply, and this is probably the major obstacle to the contemporary scientific study of suicide.

Most studies of suicide are cross-sectional and static. Future research should include more social developmental designs (Blumenthal and Kupfer 1990). There is still very little solid knowledge about the social dynamics or ‘‘suicidal careers’’ of eventual suicides (Maris 1990). For example, it is well known that successful suicides tend to be socially isolated at the time of death, but how they came to be that way is less well understood. Even after almost a hundred years of research the relationship of suicide to social class, occupation, and socioeconomic status is not clear.

A major issue in the study of suicide is rational suicide, active euthanasia, the right to die, and appropriate death. With a rapidly aging and more secular population and the spread of the acquired immune defiency (AIDS) virus, the American public is demanding more information about and legal rights to voluntary assisted death (see the case of Nico Speijer in the Netherlands in Diekstra et al. 1989). The right to die and assisted suicide have been the focus of a few recent legal cases (Humphry and Wickett 1986; Battin and Maris 1983). Rosewell Gilbert, an elderly man who was sentenced to life imprisonment in Florida for the mercy killing of his sick wife, was pardoned by the governor of Florida (1990). However, in 1990, the U.S. Supreme Court (Cruzon v. the State of Missouri) ruled that hospitals have the right to force-feed even brain-dead patients. The Hemlock Society has been founded by Derek Humphry to assist those who wish to end their own lives, make living wills, or pass living will legislation in their states

(however, see the New York Times, February 8, 1990, p. A18). Of course, the state must assure that the right to die does not become the obligation to die (e.g., for the aged). These issues are further complicated by strong religious and moral beliefs.

Should society help some people to die, and if so, who and in what circumstances? All people have to die, after all, so why not make dying free from pain, as quick as is desired, and not mutilating or lonely? One cannot help thinking of what has happened to assisted death at the other end of the life span, when help has not been available, in the case of abortion. Women often mutilate themselves and torture their fetuses by default. The same thing usually happens to suicides when they shoot themsleves in the head in a drunken stupor in a lonely bedroom or hotel room. Obviously, many abortions and most suicides are not ‘‘good deaths.’’

Euthanasia is not a unitary thing. It can be active or passive, voluntary or involuntary, and direct or indirect. A person can be against one type of euthanasia but in favor of another. ‘‘Active euthanasia’’ is an act that kills, while ‘‘passive euthanasia’’ is the omission of an act, which results in death. For example, passive or indirect euthanasia could consist of ‘‘no-coding’’ terminal cancer or heart patients instead of resuscitating them or not doing cardiopulmonary resuscitation after a medical crisis.

‘‘Voluntary euthanasia’’ is death in which the patient makes the decision (perhaps by drafting a living will), as opposed to ‘‘involuntary euthanasia,’’ in which someone other than the patient (e.g., if the patient is in a coma) decides (the patient’s family, a physician, or a nurse).

‘‘Direct euthanasia’’ occurs when death is the primary intended outcome, in contrast to ‘‘indirect euthanasia,’’ in which death is a by-product, for example, of administering narcotics to manage pain but secondarily causes respiratory failure.

All the types of euthanasia have asssociated problems. For example, active euthanasia constitutes murder in most states. It also violates a physician’s Hippocratic oath (first do no harm) and religious rules (does all life belong to God?) and has practical ambiguities (when is a patient truly hopeless?).

Passive euthanasia is often slow, painful, and expensive. For example, the comatose patient Karen Anne Quinlan lived for ten years (she survived even after the respirator was turned off) and seemed to grimace and gasp for breath. Her parents and their insurance company spent thousands of dollars on what proved to be a hopeless case. The U.S. Supreme Court ruled in Cruzan (1990) that hospitals cannot be forced to discontinue feeding comatose patients.

In a case in which the author served as an expert, Elizabeth Bouvia, a quadriplegic cerebral palsy patient in California, sued to avoid being force-fed as a noncomatose patient. Her intention was to starve herself to death in the hospital. The California Supreme Court upheld Bouvia’s right to refuse treatment, but others called the court’s decision ‘‘legal suicide.’’

A celebrated spokesperson for euthanasia in the form of assisted suicide has been Derek Humphry, especially in his best-selling book Final Exit (1996). Rational assisted suicide (Humphry assisted in his first wife’s death and in the death of his father-in-law), even for the terminally ill within six months of death, has proved highly controversial, particularly to Catholics and the religious right. Basically, Humphry has written a ‘‘how-to’’ book on the practicalities of suicide for the terminaly ill.

His preferred rational suicide technique is to ingest four or five beta-blocker tablets and 40 to 60 100-mg tablets of a barbituate (perhaps in pudding or Jell-O), taken with Dramamine (to settle the stomach), vodka (or one’s favorite whiskey), and a plastic bag over the head loosely fixed by a rubber band around the neck. Humphry recommends against guns (too messy), cyanide (too painful), hanging (too graphic), jumping (one could land on another person), and other mutilating, violent, painful, or uncertain methods.

One of the big questions about Final Exit is its potential abuses, for example, by young people with treatable, reversible depression. Having the lethal methods for suicide described in such vivid, explicit details worries many people that suicide will become too easy and thus often will be inappropriate. Yet Humphry shows that it is hard to get help with self-deliverance without fear of penalties. He argues that laws need to be changed to permit and specify procedures for physician-as-

sisted suicide for the terminally ill under highly controlled conditions.

A few states have undertaken such reforms to permit legal assisted death. For example, Initiative 119 in the fall of 1991 in Washington and Proposition 161 in the fall of 1992 in California would have provided ‘‘aid in dying’’ for a person if (1) two physicians certified that the person was within six months of (natural) death (i.e., terminally ill), (2) the person was conscious and competent, and (3) the person signed a voluntarily written request to die witnessed by two impartial, unrelated adults. Both referenda failed by votes of about 45 percent in favor and 55 percent against.

Humphry waged a similar legal battle in Oregon, first as president of the Hemlock Society and later as president of the Euthanasia Research and Guidance Organization (ERGO) and the Oregon Right to Die organization. On November 4, 1994, Oregon became the first state to permit a doctor to prescribe lethal drugs expressly and explicitly to assist in a suicide (see Ballot Measure 16). The National Right to Life Committee effectly blocked the enactment of this law until-1997, when the measure passed overwhelmingly again. On March 25, 1998, an Oregon woman in her mid-eighties stricken with cancer became the first known person to die in the United States under a doctorassisted suicide law (most, if not all, of Dr. Jack Kervorkian’s assisted suicides have probably been illegal).

Physician-assisted suicide has been practiced for some time in the Netherlands. On February 10, 1993, the Dutch Parliment voted 91 to 45 to allow euthanasia. To be eligible for euthanasia or assist- ed-suicide in the Netherlands, one must (1) act voluntarily, (2) be mentally competent, (3) have a hopeless disease without prospect for improvement, (4) have a lasting longing (or persistent wish) for death, (5) have assisting doctor consult at least one colleague, and (6) have written report drawn up afterward.

The Dutch law opened the door for similar legislation in the United States, although the U.S. Supreme court seems to have closed that door shut in Washington and New York. Box 1 discusses reviews of Dr. Herbert Hendin’s Seduced by Death, which opposes physician-assisted death the United States and the Netherlands. While the idea of legal assisted suicide will remain highly contro-

versial and devisive, it is quite likely that bills similar to Oregon’s Measure 16 will pass in other states in the next decade. A key issue will be safeguards against abuses (for example, Hendin argues that physicians in the Netherlands have decided on their own in some cases to euthanize patients).

THE DUTCH CASE

The following are excerpts from reviews of Dr. Herbert Hendin’s Seduced by Death, Doctors, Patients, and the Dutch Cure (Norton 1997). See Suicide and Life-Threatening Behavior 28:2, 1998.

On June 26, 1997, the United States Supreme Court handed down a unanimous decision on physician-assisted suicide. All nine justices concurred that both New York and Washington’s state bans on the practice should stand.

The picture [Hendin paints in the Netherlands] is a frightening one of excessive reliance on the judgment of physicians, a consensual legal system that places support of the physician above individual patient rights in order to protect the euthanasia policy, the gradual extension of practice to include administration of euthanasia without consent in a substantial number of cases, and psychologically na-

ive abuses of power in the doctor-patient relationship.

[For example:] Many patients come into therapy with sometimes conscious but often more unconscious fantasies that cast the therapist in the role of executioner . . . It may also play into the therapist’s illusion that if he cannot cure the patient, no one else can either.’’ (Seduced by Death, p. 57)

Samuel Klagsburn, M.D., says of Hendin’s argument: ‘‘He is wrong . . . suffering needs to be addressed as aggressively as possible in order to stop unnecessary suffering.’’

Hendin claims that in the Netherlands, ‘‘despite legal sanction, 60% of [physicianassisted suicide and death] cases are not reported, which makes regulation impossible.’’

Hendin goes on to argue that ‘‘a small but significant percentage of American doctors are now practicing assisted suicide, euthanasia, and the ending of patients’ lives without their consent.’’ But one also has to wonder: what

about all those patients being forced to live and suffer without the patients’ consent?

Dr. Hendin is, after all, the former Executive Director and current Medical Director of the American Foundation for Suicide Prevention. What would really be news is if Hendin came out in favor of physician-assisted death. Certainly, there are abuses of any policy. But is that enough of a reason to fail to assist fellow human beings in unremitting pain to die more easily? Death is one the most natural things there is and often is the only relief.

One of the most controversial advocates of physician-assisted suicide (‘‘medicide’’) has been Dr. Kervorkian (Kevorkian 1991). Public awareness of assisted suicide and whether it is rational has foused largely on Kervorkian, the ‘‘suicide doctor.’’ As of early 1999, Kervorkian had assisted in over 100 suicides.

Initially, with Janet Adkins, Kervorkian used a suicide machine, which he dubbed a ‘‘mercitron.’’ This machine provided a motor-driven, timed release of three intravenous bottles; in succession, they were (1) thiopental or sodium pentathol (an anesthetic that produces rapid unconsciousness),

(2) succinycholine (a muscle paralyzer like the curare used in Africa use in poison darts to hunt monkeys), and (3) postassium chloride to stop the heart. The metcitron was turned on by the wouldbe suicide. Because of malfunctions in the suicide machine, almost all of Kervorkian’s suicides after Atkins were accomplished with a simple facial mask hooked up to a hose and a carbon monoxide cannister, with the carbon monoxide flow being initiated by the suicide. For most nonnarcotic users or addicts, 20 to 30 milligrams of intravenous injected morphine would cause death.

All of Kervorkian’s first clients were women, and most were single, divorced, or widowed. Almost all were not terminally ill or at least probably would not have died within six months. The toxicology reports at autopsy (by Frederick Rieders; the author spoke with Dr. Dragovic, the Oakland County, Michigan, medical examiner to obtain these data) showed that only two of the eight assisted suicides had detectable levels of antidepressants in their blood at the time of death. It could be concluded that Kervorkian’s assisted suicides were for the most part not being treated for depressive disorders.

Given Kervorkian’s zealous pursuit of active euthanasia, one suspects that at least his early assisted suicides were not adequately screened or processed, for example, in accordance with the Dutch rules (above) or other safeguards. Strikingly, Hugh Gale is reputed to have asked Kervorkian to take off the carbon monoxide mask and terminate the dying process and perhaps was ignored by Kervorkian.

It is difficult to be objective about assisted suicide. Paradoxically, Kevorkian may end up setting euthanasia and doctor-assisted suicide back several years. Not only has he lost (1991) his Michigan medical license (he was a pathologist) and been charged with murder (after videotaping the dying of an assisted suicide for a television program), but Michigan and many other states (including South Carolina) have introduced bills to make previously legal assisted suicide a felony, with concurrent fines and imprisonment.

These new laws may have a chilling effect on both active and passive euthanasia, even in the case of legitimate pain control (‘‘palliative care’’) previously offered to dying patients by physicians and nurses. For example, in Michigan it is now a felony to assist a suicide. People who want selfdeliverance from their final pain and suffering will be more likely to mutilate themselves, die alone and disgraced, and feel generally abandoned in their time of greatest need.

Kervorkian needs to be separated from the issue of assisted suicide. However, the issue of physician-assisted suicide or death itself is not silly and transitory.

Everyone has to die eventually, and many people will suffer machine-prolonged debilitating illness and pain that diminishes the quality of their lives. Suicide and death and permanent annnihilation of consciousness (if there is no afterlife) are effective means of pain control. This refers primarily to physical pain, but psychological pain also can be excruciating. Pain cannot always be controlled short of death. Most narcotics risk respiratory death. Furthermore, narcotics often cause altered consciousness, nightmares, nausea, panic, long periods of disrupted consciousness and confusion, and addiction.

Pain control technology is progressing rapidly (e.g., spinal implant morphine pumps). There are

hospices that encourage the use classic painkilling drinks such as Cicely Saunder’s ‘‘Brompton’s cocktail’’ (a mixed drink of gin, Thorazine, cocaine, heroin, and sugar). It is also possible to block nerves or utilize sophisticated polypharmacy to soften pain.

However, some pain is relatively intractable (e.g., that from bone cancer, lung disease with pneumonia, congestive heart failure in which patients choke to death on their own fluids, gastrointestinal obstructions, and amputation). A few physicians have made the ludricrous death-in-life proposal to give hopeless terminally ill patients general anesthesia to control their pain. People do always get well or feel better. Sometimes they just need to die, not be kept alive to suffer pointlessly. Anyone deserves to be helped to die in such instances.

REFERENCES

Baechler, Jean 1979 Suicides. New York: Basic Books.

Battin, Margaret P., and Ronald W. Maris, eds. 1983 Suicide and Ethics. New York: Human Sciences Press.

Blumenthal, Susan J., and David J. Kupfer, eds. 1990.

Suicide over the Life Cycle: Risk Factor Assessment, and Treatment of Suicidal Patients. Washington, D.C.: American Psychiatric Press.

Diekstra, René F. W., Ronald W. Maris, Stephen Platt, Armin Schmidtke, and Gernot Sonneck, eds. 1989

Suicide and Its Prevention: The Role of Attitude and Imitation. Leiden: E.J. Brill.

Douglas, Jack D. 1967 The Social Meanings of Suicide. Princeton, N.J.: Princeton University Press.

Durkheim, Emile. (1897) 1951 Suicide. New York:

Free Press.

Freud, Sigmund (1917) 1953 ‘‘Mourning and Melancholia.’’ In Standard Edition of the Complete Works of Sigmund Freud. London: Hogarth Press.

Gabennesch, Howard 1988 ‘‘When Promises Fail: A Theory of Temporal Fluctuations in Suicide.’’ Social Forces 67:129–145.

Gibbs, Jack P., and W. T. Martin 1964 Status Integration and Suicide. Eugene: University of Oregon Press.

Gibbs, Jewelle Taylor, ed. 1988 Young, Black, and Male in America: An Endangered Species. Dover, Mass.: Auburn House.

Henry, Andrew F., and James F. Short 1954 Suicide and Homicide. New York: Free Press.

Holinger, Paul C. 1987 Violent Deaths in the United States: An Epidemiological Study of Suicide, Homicide, and Accidents. New York: Guilford.

Humphry, Derek 1996 Final Exit. New York: Dell.

———, and Ann Wickett 1986 The Right to Die: Understanding Euthanasia. New York: Harper & Row.

Kessler, Ronald C., and H. Stripp 1984 ‘‘The Impact of Fictional Television Stories on U.S. Fatalities: A Replication.’’ American Journal of Sociology 90:151–167.

Kervorkian, Jack 1991 Prescription Medicine. Buffalo,

N.Y.: Prometens.

Lann, Irma S., Eve K. Mościcki, and Ronald W. Maris, eds. 1989 Strategies for Studying Suicide and Suicidal Behavior. New York: Guilford.

Maris, Ronald W. 1969 Social Forces in Urban Suicide. Chicago: Dorsey.

———1981. Pathways to Suicide: A Survey of Self-Destruc- tive Behaviors. Baltimore: Johns Hopkins University Press.

———1989. ‘‘The Social Relations of Suicide.’’ In Douglas Jacobs and Herbert N. Brown, eds., Suicide, Understanding and Responding: Harvard Medical School Perspectives, Madison, Conn.: International Universities Press.

———1990. The Developmental Perspective of Suicide.’’ In Antoon Leenaars, ed., Life Span Perspectives of Suicide. New York: Plenum.

———1997 ‘‘Suicide.’’ In Renato Pulbecco, ed., Encyclopedia of Human Biology.

———, Alan L. Berman, John T. Maltsberger, and Robert I. Yufit, eds. 1992 Assessment and Prediction of Suicide. New York: Guilford.

Menninger, Karl 1938 Man against Himself. New York: Harcourt, Brace.

Pescosolido, Bernice A., and Sharon Georgianna 1989 ‘‘Durkheim, Suicide, and Religion: Toward a Network Theory of Suicide.’’ American Sociological Review

54:33–48.

Phillips, David P. 1974 ‘‘The Influence of Suggestion on Suicide.’’ American Sociological Review 39:340–354.

Pokorny, Alex D. 1983 ‘‘Prediction of Suicide in Psychiatric Patients.’’ Archives of General Psychiatry 40:249–257.

———, Katherine Lesyna, and David T. Paight 1991 ‘‘Suicide and the Media.’’ In Ronald W. Maris, et al., eds., Assessment and Prediction of Suicide. New York: Guilford.

Robins, El: 1981 The Final Months. New York: Oxford

University Press.

Shneidman, Edwin S. 1985 Definition of Suicide. New York: Wiley Interscience.

Stack, Stephen 1982 ‘‘Suicide: A Decade Review of the Sociological Literature.’’ Deviant Behavior 4:41–66.

Wasserman, Ira M. 1989 ‘‘The Effects of War and Alcohol Consumption Patterns on Suicide: United States, 1910–1933.’’ Social Forces 67:129–145.

RONALD W. MARIS

SUPERNATURALISM

See Religious Orientations.

SURVEY RESEARCH

Survey research is the method most frequently used by sociologists to study American society and other large societies. Surveys allow sociologists to move from a relatively small sample of individuals who are accessible as carriers of information about themselves and their society to the broad contours of a large population, such as its class structure and dominant values. Surveys conform to the major requirements of the scientific method by allowing a considerable (though by no means perfect) degree of objectivity in approach and allowing tests of the reliability and validity of the information obtained.

Like many other important inventions, a survey is composed of several more or less independent parts: sampling, questioning, and analysis of data. The successful combination of those elements early in the twentieth century gave birth to the method as it is known today. (Converse 1987 provides a history of the modern survey).

SAMPLING

The aspect of a survey that laypersons usually find the most mysterious is the assumption that a small sample of people (or other units, such as families or firms) can be used to generalize about the much larger population from which that sample is drawn. Thus, a sample of 1,500 adults might be drawn to represent the population of approximately 200 million Americans over age 18 in the year 2000. The sample itself is then used to estimate the extent to which numerical values calculated from it (for example, the percentage of the sample answering ‘‘married’’ to a question about marital status) are likely to deviate from the values that

would have been obtained if the entire population over age 18 had been surveyed. That estimate, referred to as ‘‘sampling error’’ (because it is due to having questioned only a sample, not the full population), is even stranger from the standpoint of common sense, much like pulling oneself up by one’s own bootstraps.

Although a sample of only 1,500 may be needed to obtain a fairly good estimate for the entire U.S. adult population, this does not mean that a much smaller sample is equally adequate for, say, a city of only 100,000 population. It is the absolute size of the sample that primarily determines the precision of an estimate, not the proportion of the population that is drawn for the sample—another counterintuitive feature of sampling. This has two important implications. First, a very small sample, for example, two or three hundred, is seldom useful for surveys, regardless of the size of the total population. Second, since it is often subparts of the sample, for example, blacks or whites, that are of primary interest in a survey report, it is the size of each subpart that is crucial, not the size of the overall sample. Thus, a much larger total sample may be required when the goal is to look separately at particular demographic or social subgroups.

All the estimates discussed in this article depend on the use of probability sampling, which implies that at crucial stages the respondents are selected by means of a random procedure. A nonprobability sampling approach, such as the proverbial person-in-the-street set of interviews, lacks scientific justification for generalizing to a larger population or estimating sampling error. Consumers of survey information need to be aware of the large differences in the quality of sampling that occur among organizations that claim to do surveys. It is not the case in this or other aspects of survey research that all published results merit equal confidence. Unfortunately, media presentations of findings from surveys seldom provide the information needed to evaluate the method used in gathering the data.

The theory of sampling is a part of mathematics, not sociology, but it is heavily relied on by sociologists and its implementation with real populations of people involves many nonmathematical problems that sociologists must try to solve. For example, it is one thing to select a sample of people according to the canons of mathematical

theory and quite another to locate those people and persuade them to cooperate in a social survey. To the extent that intended respondents are missed, which is referred to as the problem of nonresponse, the scientific character of the survey is jeopardized. The degree of jeopardy (technically termed ‘‘bias’’) is a function of both the amount of nonresponse and the extent to which the nonrespondents differ from those who respond. If, for example, young black males are more likely to be missed in survey samples than are other groups in the population, as often happens, the results of the survey will not represent the entire population adequately. Serious survey investigators spend a great deal of time and money to reduce nonresponse to a minimum, and one measure of the scientific adequacy of a survey report is the information provided about nonresponse. In addition, an active area of research on the survey method consists of studies both of the effects of nonresponse and of possible ways to adjust for them. (for an introduction to sampling in social surveys, see Kalton 1983; for a more extensive classic treatment, see Kish 1965).

QUESTIONS AND QUESTIONNAIRES

Unlike sampling, the role of questions as a component of surveys often is regarded as merely a matter of common sense. Asking questions is a part of all human interaction, and it is widely assumed that no special skill or experience is needed to design a survey questionnaire. This is true in the sense that questioning in surveys is seldom very different from questioning in ordinary life but incorrect in the sense that many precautions are needed in developing a questionnaire for a general population and then interpreting the answers.

Questionnaires can range from brief attempts to obtain factual information (for example, the number of rooms in a sample of dwelling units) or simple attitudes (the leaning of the electorate toward a political candidate) to extensive explorations of the respondents’ values and worldviews. Assuming that the questions have been framed with a serious purpose in mind—an assumption not always warranted because surveys are sometimes initiated with little purpose other than a desire to ask some ‘‘interesting questions’’—there are two important principles to bear in mind: one

about the development of the questions and the other about the interpretation of the answers.

The first principle is the importance of carrying out as much pilot work and pretesting of the questions as possible, because not even an experienced survey researcher can foresee all the difficulties and ambiguities a set of questions holds for the respondents, especially when it is administered to a heterogeneous population such as that of the United States. For example, a frequently used question about whether ‘‘the lot of the average person is getting worse’’ turned out on close examination to confuse the respondents about the meaning of ‘‘lot,’’—with some taking it to refer to housing lots. Of course, it is still useful to draw on expert consultation where possible and to become familiar with discussions of questionnaire design in texts, especially the classic treatment by Payne (1951) and more recent expositions such as that by Sudman and Bradburn (1987).

Pilot work can be done in a number of ways, for example, by having a sample of respondents think aloud while answering, by listening carefully to the reactions of experienced interviewers who have administered the questionnaire in its pretest form, and, perhaps best of all, by having investigators do a number of practice interviews. The distinction between ‘‘pilot’’ and ‘‘pretest’’ questionnaires is that the former refer to the earlier stages of questionnaire development and may involve relatively unstructured interviewing, while the latter are closer to ‘‘dress rehearsals’’ before the final survey.

The main principle in interpreting answers is to be skeptical of simple distributions of results often expressed in percentage form for a particular question, for example, 65 percent ‘‘yes,’’ 30 percent ‘‘no,’’ 5 percent ‘‘don’t know.’’ For several reasons, such absolute percentages suggest a meaningfulness to response distributions that can be misleading. For one thing, almost any important issue is really a cluster of subissues, each of which can be asked about and may yield a different distribution of answers. Responses about the issue of ‘‘gun control’’ vary dramatically in the United States depending on the type of gun referred to, the amount and method of control, and so forth. No single percentage distribution or even two or three distributions can capture all this variation, nor are such problems confined to questions about

attitudes: Even a seemingly simple inquiry about the number of rooms in a home involves somewhat arbitrary definitions of what is and is not to be counted as a room, and more than one question may have to be asked to obtain the information the investigator is seeking. By the same token, care must be taken not to overgeneralize the results from a single question, since different conclusions might be drawn if a differently framed question were the focus. Indeed, many apparent disagreements between two or more surveys disappear once one realizes that somewhat different questions had been asked by each even though the general topic (e.g., gun control) may look the same.

Even when the substantive issue is kept constant, seemingly minor differences in the order and wording of questions can change percentage distributions noticeably. Thus, a classic experiment from the 1940s showed a large difference in the responses to a particular question depending on whether a certain behavior was said to be ‘‘forbidden’’ rather than ‘‘not allowed’’: To the question, ‘‘Do you think the United States should forbid public speeches against democracy?’’ 54 percent said yes, [Forbid], but to the question, ‘‘Do you think the United States should allow public speeches against democracy?’’ 75 percent said no (do not allow). This is a distinction in wording that would not make a practical difference in real life, since not allowing a speech would have the same consequence as forbidding it, yet the variation in wording has a substantial effect on answers. Experiments of this type, which are called ‘‘splitballot experiments,’’ frequently are carried out by dividing a national sample of respondents in half and asking different versions of the question to each half on a random basis. If the overall sample is large enough, more than two variations can be tested at the same time, and in some case more complex ‘‘factorial designs’’ are employed to allow a larger number of variations (see Rossi and Nock [1982] for examples of factorial surveys).

The proportion of people who answer ‘‘don’t know’’ to a survey question also can vary substan- tially—by 25 percent or more—depending on the extent to which that answer is explicitly legitimized for respondents by mentioning it along with other alternatives (‘‘yes,’’ ‘‘no,’’ ‘‘don’t know’’) or omitted. In other instances, the location of a question in a series of questions has been shown to affect answers even though the wording of the question

is not changed. For example, a widely used question about allowing legalized abortion in the case of a married woman who does not want more children produces different answers depending entirely on its position before or after a question about abortion in the case of a defective fetus. Thus, the context in which a question is asked can influence the answers people give. These and a large number of other experiments on the form, wording, and context of survey questions are reported by Schuman and Presser (1981) (see Turner and Martin [1984] for several treatments of survey questioning, as well as more recent volumes by Schwarz and Sudman [1996] and Sudman et al. [1996] with a cognitive psychological emphasis).

ANALYSIS

Although questioning samples of individuals may seem to capture the entire nature of a survey, a further component is vital to sociologists: the logical and statistical analysis of the resulting data. Responses to survey questions do not speak for themselves, and in most cases even the simple distribution of percentages to a single question calls for explicit or implicit comparison with another distribution, real or ideal. To report that 60 percent of a sample is satisfied with the actions of a particular leader may be grounds for either cheering or booing. It depends on the level of satisfaction typical for that leader at other times or for other individuals or groups in comparable leadership positions. Thus, reports of survey data should include these types of comparisons whenever possible. This is why for sociologists the collection of a set of answers is the beginning and not the end of a research analysis.

More generally, most answers take on clear meaning primarily when they are used in comparisons across time (for example, responses of a sample this year compared with responses of a sample from the same population five years ago), across social categories such as age and education, or across other types of classifications that are meaningful for the problem being studied. Moreover, since any such comparison may produce a difference that is due to chance factors because only a sample was drawn rather than to a true difference between time points or social categories, statistical testing is essential to create confidence that the difference would be found if the

entire population could be surveyed. In addition, individual questions sometimes are combined into a larger index to decrease idiosyncratic effects resulting from any single item, and the construction of this type of index requires other preliminary types of statistical analysis.

As an example of survey analysis, sociologists often find important age differences in answers to survey questions, but since age and education are negatively associated in most countries—that is, older people tend to have less education than do younger people—it is necessary to disentangle the two factors in order to judge whether age is a direct cause of responses or only a proxy for education. Moreover, age differences in responses to a question can represent changes resulting from the aging process (which in turn may reflect physiological, social, or other developmental factors) or reflect experiences and influences from a particular historical point in time (‘‘cohort effects’’). Steps must be taken to distinguish these explanations from one another. At the same time, a survey analyst must bear in mind and test the possibility that a particular pattern of answers is due to ‘‘chance’’ because of the existence of sampling error.

Thus, the analysis of survey data can be quite complex, well beyond, though not unrelated to, the kinds of tables seen in newspaper and magazine presentations of poll data. (The terms ‘‘poll’’ and ‘‘survey’’ are increasingly interchangeable, with the main difference being academic and governmental preference for ‘‘survey’’ and media preference for ‘‘poll.’’) However, such thorough analysis is important if genuine insights into the meaning of answers are to be gained and misinterpretations are to be avoided. (A comprehensive but relatively nontechnical presentation of the logic of survey analysis is provided by Rosenberg [1968]. Among the many introductory statistical texts, Agresti and Finlay [1997] leans in a survey analytic direction.)

MODE OF ADMINISTRATION

Although sampling, questioning, and analysis are the most fundamental components, decisions about the mode of administering a survey are also important. A basic distinction can be made between selfadministered surveys and those in which interviewers are used. If it is to be based on probability sampling of some sort, self-administration, usually is carried out by mailing questionnaires to respon-