should we really “kill” the messenger? framing physician-assisted suicide and the role of...

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This article was downloaded by: [UQ Library] On: 11 October 2014, At: 10:02 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK Political Communication Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/upcp20 Should We Really “Kill” the Messenger? Framing Physician-Assisted Suicide and the Role of Messengers Mark R. Joslyn a & Donald P. Haider-Markel a a Associate Professors of Political Science , University of Kansas Published online: 22 Nov 2006. To cite this article: Mark R. Joslyn & Donald P. Haider-Markel (2006) Should We Really “Kill” the Messenger? Framing Physician-Assisted Suicide and the Role of Messengers, Political Communication, 23:1, 85-103 To link to this article: http://dx.doi.org/10.1080/10584600500477104 PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions

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Page 1: Should We Really “Kill” the Messenger? Framing Physician-Assisted Suicide and the Role of Messengers

This article was downloaded by: [UQ Library]On: 11 October 2014, At: 10:02Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House,37-41 Mortimer Street, London W1T 3JH, UK

Political CommunicationPublication details, including instructions for authors and subscription information:http://www.tandfonline.com/loi/upcp20

Should We Really “Kill” the Messenger? FramingPhysician-Assisted Suicide and the Role of MessengersMark R. Joslyn a & Donald P. Haider-Markel aa Associate Professors of Political Science , University of KansasPublished online: 22 Nov 2006.

To cite this article: Mark R. Joslyn & Donald P. Haider-Markel (2006) Should We Really “Kill” the Messenger? FramingPhysician-Assisted Suicide and the Role of Messengers, Political Communication, 23:1, 85-103

To link to this article: http://dx.doi.org/10.1080/10584600500477104

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) containedin the publications on our platform. However, Taylor & Francis, our agents, and our licensors make norepresentations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of theContent. Any opinions and views expressed in this publication are the opinions and views of the authors, andare not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon andshould be independently verified with primary sources of information. Taylor and Francis shall not be liable forany losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoeveror howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use ofthe Content.

This article may be used for research, teaching, and private study purposes. Any substantial or systematicreproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in anyform to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions

Page 2: Should We Really “Kill” the Messenger? Framing Physician-Assisted Suicide and the Role of Messengers

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Political Communication, 23:85–103Copyright 2006 Taylor & Francis Group, LLCISSN: 1058-4609 print / 1091-7675 onlineDOI: 10.1080/10584600500477104

Mark R. Joslyn and Donald P. Haider-Markel are Associate Professors of Political Scienceat the University of Kansas.

A previous version of this article was presented at the annual meeting of the AmericanPolitical Science Association in August 2001. The authors thank Richard Flickinger, Paul Quirk,David Darmofal, the editor, and three anonymous reviewers for their comments on an earlierversion. The Policy Research Institute at the University of Kansas supported this research.

Address correspondence to Mark R. Joslyn, Department of Political Science, 1541 LilacLane, University of Kansas, Lawrence, KS 66044-3177, USA. E-mail: [email protected]

Should We Really “Kill” the Messenger?Framing Physician-Assisted Suicide

and the Role of Messengers

MARK R. JOSLYN and DONALD P. HAIDER-MARKEL

Undoubtedly, framing political issues is an effective means of influencing the distri-bution of opinion. But while most studies have shown the effectiveness of alternativeissue frames on opinion, they largely ignore the role of the messenger. Our researchexamines whether message content or messengers are more important in influencingopinion. Four experimental conditions and a control were embedded in a statewidesurvey, allowing an explicit comparison between the impact of frames comprisingmessage content alone and the same frames attributed to public figures identifiedwith physician-assisted suicide. Results show that an attributed source is no moreeffective than content alone in influencing opinion on physician-assisted suicide andthat the messenger might in fact reduce the intended influence of the message. Weconclude with a discussion of our findings within the larger literature on politicalpersuasion and attitude change.

Keywords framing, messenger, physician assisted suicide, public opinion

The manner in which an issue is presented or framed has long been central to ourunderstanding of political conflict and its eventual resolution (Schattschneider, 1960;Kalwinsky, 1998; Riker, 1986). Contemporary research on issue framing has largelyconfirmed our intuitions. Frames serve to organize an individual’s thinking on an issue,weaving various threads of content and context into a coherent story line that “suggestswhat the controversy is about, the essence of the issue” (Gamson & Modigliani, 1989,p. 143). These frames, in turn, shape public opinion, sometimes to a considerable degree(Sniderman, 1993).

The message-response model dominates the framing literature (Nelson, 1999). Mes-sage content is varied and respondent dispositions recorded in an effort to examine thefundamental dynamics of political persuasion (Jacoby, 2000). Although this formulation

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86 Mark R. Josyln and Donald P. Haider-Markel

draws attention to the interaction of message content and receiver psychology, it largelyignores the potentially important role of messengers.

A multitude of studies have examined the impact of competing political messages,yet few have examined the influence of competing messengers or the relative effects ofmessenger and message versus message alone (but see Druckman, 2001). This omissionmight appear strange to the layperson, since in politics few messages stand alone with-out being attributed to an individual or group. Indeed, most news media outlets seekindividuals who are willing to voice a particular point of view (Klarevas, 2003). Giventhe political premium placed on television performance and media personalities (Klarevas,2003; Patterson, 1993; Schmuhl, 1992), a more vigorous research emphasis on the mes-senger appears warranted (Druckman, 2001).

In this article, we examine the role of messengers. Our research centers on theimportant and controversial issue of physician-assisted suicide (PAS). In an experimentaldesign embedded within a state-wide survey, competing frames of PAS were presentedto respondents, one frame characterizing PAS predominantly in religious terms, stress-ing the sanctity of life, and the other emphasizing people’s right to terminate their ownlife with the assistance of a physician. To test messenger impact, additional respondentsreceived these same frames but with content attributed to a specific messenger. We werethus able to address the obvious but crucial question of whether frames influence opin-ion about PAS, and more importantly, examine whether messages (frames) attributed tospecific messengers have any additional influence on opinion toward PAS beyond themessage alone.

Issue Framing and Messengers

Scholars of public opinion have long recognized that citizens use heuristics to compen-sate for their lack of substantive knowledge about politics (Berelson et al., 1954; Downs,1957). Although the implications of citizens using heuristics or information shortcuts tomake political decisions remains an open and lively area of inquiry (Kuklinski & Hurley,1994; Lupia, 1994), it appears that reasonable judgments are nevertheless possible evenwhen citizens lack general political acumen, sophistication, or information about therelevant issue (Lupia & McCubbins, 1998).

Existing research designs typically encourage respondents to use message content asa heuristic device, allowing citizens to infer from a few choice words and sentences theessence of an issue. Messages, or issue frames, tend to selectively activate specific po-litical considerations that are found to weigh prominently in judgmental processes (Iyengar& Kinder, 1987; Jacoby, 2000; Joslyn & Haider-Markel, 2002). This cognitive dynamicis of course nothing new and fits squarely into the classic stimulus-response models ofsocial psychology (Hovland, Janis, & Kelley, 1953). Rather, what appears novel is asustained research effort on the ability of message content to shape opinion. Most re-search on issue framing has examined the influence of message content, probing foropinion differences that emerge from exposure to competing messages (e.g., Kinder &Sanders, 1990). While others have included a messenger, the content attributed to thatmessenger represents a relatively small fraction of the entire message (Nelson & Oxley,1999).

The degree to which these research designs reflect political reality is questionable.For example, a fairly typical experimental research frame includes references to “whatsome people say” or “what some or most Americans believe” about a specified issue(Druckman, 2001; Iyengar & Kinder, 1987; Jacoby, 2000). However vague this initial

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Framing Physician-Assisted Suicide 87

reference, messages are then framed so as to plainly mimic contemporary debate, evok-ing conflicting values that a given issue represents (Haider-Markel & Joslyn, 2001; Kinder& Sanders, 1990). It in fact appears that most researchers go out of their way to ensurethat the issue frame cannot be attributed to an identifiable source or messenger. Al-though we recognize that this design allows researchers to tackle knotty questions ofcause and effect, it nevertheless raises additional concerns of authenticity. It is far morelikely that actual media reports about specific issues would include statements by rel-evant public figures and notable personalities who enjoy established reputations in cer-tain policy venues (Calvert, 1987; Klarevas, 2003).

Research has demonstrated that government officials are the main source of mostpolitical stories reported by the wire services and national and local media (Dunwoody& Shields, 1986). Prominent political figures such as the president and members ofCongress provide particularly useful information cues for an increasingly inattentive public(Klarevas, 2003; Lindaman & Haider-Markel, 2002; Lockerbie & Borrelli, 1990). Thesefigures carry political reputations that provide citizens with important contextual infor-mation for evaluations (Carmines & Kuklinski, 1990; Zaller, 1992). Similarly, sourcesthat have gained recognition as “experts” through media exposure tend to be utilizedrepeatedly, while reporters often neglect other potential but less well-known sources(Dunwoody & Ryan, 1987; Klarevas, 2003; Shepherd, 1981). Further, interest groupsand other organizations encourage citizens to make “information shortcuts” for determin-ing their own positions. For example, if trial lawyers support a policy, a citizen mightdecide she or he should also support the policy (Lupia, 1994). In short, specific messengersframe political issues; content alone appears to be the exception rather than the rule.

To be sure, the existing literature and the gaps in current research remind us ofLaswell’s enduring and organizing question for communication research: “Who said whatto whom with what effect?” Although messengers (who) and their characteristics havebeen the focus of persuasion studies in social psychology for many years (Hovland &Weiss, 1951–1952; Petty & Wegener, 1998), political scientists have only recently begunto examine the implications of messenger and information source traits. For example,Kuklinski and Hurley (1994) demonstrated that the race of the messenger influenced arespondent’s interpretation of the message. Black respondents exposed to statements aboutBlack self-reliance were far more supportive of the idea when the statement was attrib-uted to a Black political leader. In other words, who advocated self-reliance stronglyaffected Black respondents’ agreement with the idea. More recently, Miller and Krosnick(2000) showed that perceived trustworthiness of an information source influences prim-ing. Similarly, Druckman (2001) found that source credibility limited the effects of framingon opinion.

Research also suggests that the messenger may undermine the intended effect of themessage. A source recognized as consistent with the receiver’s dispositions will likelybe more effective. If the messenger holds different political positions than the receiver,the message itself may not shape the receiver’s preferences (Kuklinski & Hurley, 1996).A similar phenomenon has been observed in direct democracy elections where politicalelites endorse or oppose ballot proposals, with voters being swayed for or against apolicy based on who has endorsed it (Karp, 1998). Thus, the source of the messageclearly provides information above and beyond the arguments presented in the message.Interacting with receiver characteristics, this information may either enhance or diminishthe persuasive power of the message itself.

In sum, existing research does indeed suggest that messengers might enhancethe impact of a message on opinion, but messengers may also reduce the impact of a

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message on opinion. In cases where respondents are receptive to both the message andthe messenger, and the message and messenger are clearly associated with a specificissue position, the messenger could enhance the effect of the issue frame in shapingopinion by priming the same heuristics as the message. However, messengers could alsolimit the influence of issue frames on opinion when respondents are less receptive to themessenger than they are to the message. In such cases, we would expect that the combi-nation of messenger and message would have no greater influence on opinion than themessage alone, and might even decrease the influence of the message.1

Our study examines the relative effects of messengers and messages. First we askhow important the messenger is in affecting public opinion. The key is how we defineimportance; importance will be determined by comparing the effects of message contentto content attributed to a messenger. The conventional method of studying source ef-fects is to expose respondents to the same message, but with different subsets of respon-dents given different sources to which the message is attributed. Any difference in opinionbetween groups would be a consequence of source factors, since all other features of thestudy are the same. By contrast, we compare the effects of the message to the effects ofthe message attributed to a source. Any variation in opinion would then stem fromdifferences between source and message. This is a crucial distinction as it allows us toestablish whether the frame (message) is what drives opinion or a frame attributed to amessenger. At present, the framing literature does not speak to this question.

We also address the secondary and related question of whether messengers activatespecific values associated with PAS, namely religiosity and individualism, to a greateror lesser extent than message content. This latter question encourages a deeper examina-tion of the effects of message content and messenger and, hopefully, a broader under-standing of the impact of issue frames.

Political Dynamics of Physician-Assisted Suicide and Opinion

Recent polls suggest that a significant majority (61%) of American adults support allow-ing medical doctors to assist terminally ill patients in committing suicide, even thoughmany Americans espouse viewpoints that suggest human life should be held dear (Gil-lespie, 1999). In addition, some states have considered policies that would legalize PAS.Several ballot initiatives addressing the subject have failed (Clark, 1997), but in 1997Oregon voters approved, for the second time, a ballot initiative that allowed for PAS bya margin of 20%.2 Given the core values at stake over PAS—the value of human lifeversus the right of individuals to determine their own destiny—it would seem that opin-ions on this issue would exhibit significant stability, making it less likely that issueframes would affect individuals regardless of the messenger (Joslyn & Haider-Markel,2002; Kalwinsky, 1998).

However, some evidence does suggest that opinions may shift when the issue issalient, such as during the course of a political campaign (Kalwinsky, 1998). For ex-ample, Detroit Free Press polls taken during the course of a 1998 Michigan PAS ballotinitiative campaign, though originally showing majority support for allowing PAS, even-tually showed majority opposition following an intensive media campaign by opponents(Bell, 1998). Additionally, Glick and Hutchinson (2001) show that public support forPAS has increased over time as the issue has received more coverage in the media (seealso Kalwinsky, 1998).

Further, PAS has attracted considerable political attention, in part, because notablepolitical entrepreneurs have championed it, even though many elected officials have

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stayed clear of the issue (Glick & Hutchinson, 2001). In particular, Dr. Jack Kevorkianhas become perhaps the most well known proponent of PAS, while the Reverend JerryFalwell has become a recognizable opponent (Clark, 1997; Kalwinsky, 1998).

But it should be clear that messengers might detract or neutralize issue frames aswell as enhance them. The two messengers we use for our study are certainly controversial,and both subsequently have supporters and detractors, with neither receiving overwhelminglyfavorable ratings in public opinion polls. For example, a 1994 national NBC News/WallStreet Journal poll of adults showed that over 33% of respondents said their feelingsabout Rev. Falwell were somewhat negative to very negative, 21% said their feelingswere somewhat positive to very positive, and the rest were neutral in their feelings. Asimilar 1998 national Gallup poll of adults showed that 40% of respondents held favor-able views of Dr. Kevorkian, while 47% held unfavorable views.3

However, in modern America there are few, if any, public figures who make theirissue positions known and also are favorably received by large majorities of the public.Public figures who broadcast their positions on controversial issues will predictably drawthe ire of a significant portion of the public. Certain messengers thus present a mixedblessing, enhancing the support of some while losing the support of others (Karp, 1998).But in testing the influence of messengers, researchers must make use of well-knownmessengers who can be credibly linked to an issue and issue position (frame). Other-wise, individuals are likely to be confused by the association of messenger and message.

Moreover, messengers are likely to prime certain opinion considerations in somerespondents but reduce the role of those same considerations in others. For example,because Dr. Kevorkian’s views on PAS are secular and focused on individualism, con-necting Dr. Kevorkian to an individualist message may lead some respondents to bemore receptive to an individual rights frame on PAS. On the other hand, the secularnature of Dr. Kevorkian’s values may actually decrease the influence of an individualrights frame for more religious respondents, simply because these respondents do notwant their views to match those of such a polarizing secular figure. Likewise, associat-ing Rev. Falwell with a pro-life message may reduce the religious considerations usedby respondents stating their position on PAS, simply because Rev. Falwell may repre-sent distasteful extremist religious views to some individuals. Nevertheless, at minimumwe expect divided public support for our messengers to affect the overall distribution ofsupport for PAS and to influence specific opinion considerations (individualism andreligiosity) as well.

Study Design and Method

For our study, a series of experimental manipulations were designed to evaluate the im-pact of message and messenger on respondent opinion about PAS. To establish causalityand still maintain the value of large-sample general population surveys, experimentaltreatments were embedded in a survey design. The treatments, assigned randomly acrossadult respondents, represented question form—content alone and content attributedto messenger—and served as our key independent variables. Responses to subsequentinquiries about respondents’ opinions on PAS provided our dependent variable.

The Survey: Sampling and Content

In the spring of 1999, a random-digit dial telephone survey of 1,200 households wasadministered in a midwestern state.4 Because the sampling of households was random,

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the working sample accurately reflected the distribution of telephone prefixes so thatareas with larger populations were represented in the sample to the same degree theywere distributed in the state. The survey asked adult participants questions about severallocal and national policy areas and took approximately 15 minutes to complete. Theresponse rate was 57% and the cooperation rate was 71%. Though somewhat bettereducated, older, and more likely to be female than the general population, the pattern ofadults that agreed to participate is consistent with most survey research of the generalpopulation (Kohut, 2004), and our sample characteristics yielded a reasonably accurateportrait of the state (see the Appendix for descriptive statistics).

To determine the relative impact of message and messenger, respondents were ran-domly assigned to one of five conditions: two contrasting messages (pro-life, n = 301;individual rights, n = 230), the same two contrasting messages attributed to two differ-ent messengers (Rev. Falwell, n = 236; Dr. Kevorkian, n = 237), and a control group(n = 203) whose members received no message and were asked only about their willing-ness to support PAS.

The Embedded Experiment: The Issue Frames and the Messengers

Survey respondents in our study were randomly assigned to one of five groups andasked whether they agreed or disagreed with the following statement: “I would be will-ing to support physician-assisted suicide” (1 = strongly agree, 7 = strongly disagree).The control group did not receive any content other than the question, while respon-dents in the remaining four groups were first exposed to one of the following frames.

Group 1: Pro-Life Frame: Recently, the issue of physician-assisted suicide has receiveda lot of public attention. Some people say that life itself is of ultimate importanceand no one should have a physician assist them in committing suicide.

Group 2: Individual Rights Frame: Recently, the issue of physician-assisted suicide hasreceived a lot of public attention. Some people say that individual rights are ofultimate importance and individuals should be free to determine their own fate in-cluding suicide and to get assistance from a physician if they choose.

Group 3: Pro-Life Frame With Messenger: Recently, the issue of physician-assisted sui-cide has received a lot of public attention. Some public figures, such as the ReverendJerry Falwell, say that life itself is of ultimate importance and no one should have aphysician assist them in committing suicide.

Group 4: Individual Rights Frame With Messenger: Recently, the issue of physician-assisted suicide has received a lot of public attention. Some public figures, such asDr. Jack Kevorkian, say that individual rights are of ultimate importance and indi-viduals should be free to determine their own fate including suicide and to getassistance from a physician if they choose.

These frames mimic the public debate on PAS. During a 2000 campaign over theballot initiative in Maine that would have allowed for PAS, proponents argued that “thetime has come for people at the end of life to be able to choose how and when they willdie” (Moore, 2000, p. A21). One medical doctor who supported the initiative argued:“Sometimes relieving suffering is more important than extending life. I don’t think the[Maine] Death with Dignity Act is perfect, but it does offer both patients and doctors achoice they don’t have so I hope it will be approved” (Moore, 2000, p. A21).

Opponents of the measure attacked potential abuses, especially by health mainte-nance organizations, but also focused on the fact that most religious denominations

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consider taking one’s own life to be a sin because it violates the sanctity of human life(Moore, 2000). In a video distributed by the Catholic Church to all 169 parishes inMaine, Bishop Joseph Gerry asked Catholics to vote against the PAS measure, arguingthat “when death comes, it must come naturally, unaided by human hands. There isa fundamental difference between allowing death, and assisting death” (Vegh, 2000, p.A3). Bishop Gerry further suggested that medical doctors could “become the possibleagents of death” (Vegh, 2000, p. A3).

Statistical Analysis and Discussion of Results

Mean responses across the experimental conditions illustrate the impact of the issueframes. Relative to the control condition, alternative issue frames appear to affect opinionin the direction anticipated. For example, relative to the control group, the significantlylower mean response in the individual rights frame indicates greater support for PAS,Ms = 4.0–4.5, t(404) = 2.1, p < .04. In addition, respondents in the pro-life frame re-ported a greater reluctance to support PAS (M = 4.8), though differences with the controlgroup did not rise to a standard acceptable level of statistical significance, Ms = 4.5–4.8,t(473) = 1.12, p < .25. By contrast, the individual rights frame, as attributed to Dr.Kevorkian, generated greater support for PAS than did the control, Ms = 3.8–4.5,t(407) = 2.8, p < .004. Finally, relative to the control group, respondents exposed to thepro-life frame attributed to Reverend Falwell were only slightly more likely to oppose PAS,but the difference was not statistically significant, Ms = 4.5–4.7, t(405) = .41, p < .80.

Multivariate Analysis

As a further test, we conducted an ordinary least squares regression analysis in an effortto rule out the potential effects of other variables on the relationships among the frames,the frames and messengers, and opinion on PAS. Researchers have reported severalindividual characteristics that influence support for PAS (Sawyer & Sobal, 1987; Weiss,1996). For example, Emanuel et al. (1996) found that persons with weak or liberalreligious affiliations were more likely to support PAS (see also Braun et al., 2001; Hamil-Luker & Smith, 1998; Joslyn & Haider-Markel, 2002; O’Neill et al., 2003; Weiss, 1996).In addition, Sawyer and Sobal (1987) found that women are more likely to supportPAS, even though other studies have not uncovered this relationship (Joslyn & Haider-Markel, 2002; O’Neill et al., 2003; Weiss, 1996). Braun et al. (2001), Joslyn and Haider-Markel (2002), and MacDonald (1998) all found that race and ethnicity strongly influ-ence opinions on PAS. Finally, MacDonald (1998) found that education and politicalideology play a significant role in shaping opinion on PAS (see also Joslyn & Haider-Markel, 2002).

Based on these findings, controls for respondent ideology, religiosity, age, educa-tion, race, and gender were included. We expected that women, the more educated,Whites, youth, and more liberal and less religious respondents would be more support-ive of PAS (see the Appendix for descriptive statistics for these variables).

In addition, Kemmelmeier et al. (1999, 2002) found that individualism beliefs had asignificant influence on support for PAS, even across different countries (see also Weiss,1996). Following their work, we included a commonly used measure of support forindividualism (Feldman, 1999), with the expectation that supporters of individualismwould be more likely to support PAS.5 Exposure to each frame/messenger was coded asone and no exposure as zero. The control group served as our omitted variable baseline.

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Our results are shown in Table 1. The regression estimates indicate that exposure tothe individual rights frame is associated with greater support for PAS—as noted by anegative sign. Likewise, Whites, liberals, the less religious, and supporters of individual-ism were more supportive of PAS. However, exposure to the pro-life frame, while in theexpected direction (positive), was not associated with greater opposition to PAS.6

Exposure to the individual rights frame attributed to Dr. Kevorkian was also associ-ated with more support for PAS while exposure to the pro-life frame attributed to Rev.Falwell was not associated with greater opposition to PAS. This finding leads to us to aninitial conclusion that messengers did not significantly enhance the influence of the is-sue frames on respondent opinion. Furthermore, based on the fact that public opinion ofRev. Falwell and Dr. Kevorkian suggests that both men are controversial and possesspolitical liabilities, and based on our initial evidence, it seems that the presence of thesemessengers is at minimum neutral and at worst potentially damaging to the effectivenessof the issue frame itself. Additional analysis is warranted.

Additional Considerations and Analysis

To further examine the influence of messengers on opinion, we conducted additionalanalyses that considered the potential interaction between messengers and important valuesassociated with the PAS frames. Although we have shown that levels of individualismand religiosity are important determinants of support for PAS, a specific messenger maynevertheless interact with their effects.

In Table 2, we present results of our OLS regression on subsets of respondentsexposed to the individual rights frame attributed to Dr. Kevorkian (M1) and the subsetof respondents exposed to the individual rights frame alone (M2). Dividing the data intosubsets allows us to cleanly interact each independent variable in the model with theopposing frames and messengers, without the high degree of multicollinearity associatedwith models that include the full data set and simply multiply two terms while leavingthe two original terms in the model (Hamilton, 1992, pp. 82–85; see also Gerber &Green, 1998; Haider-Markel & Joslyn, 2001).7

Our focus is the size of the coefficient for the individualism variable in each model.Because the individual rights frame conveys the message cleanly, without the potentialconfounding influence of a messenger, we expected that the individual rights framewould evoke values associated with individualism, and thus the coefficient for individu-alism would be larger in Model M2 than in Model M1. This is what occurred. In ModelM1, which includes the subset of respondents exposed to the individual rights framemessage and the messenger (Dr. Kevorkian), the coefficient is smaller than in ModelM2. Further, the difference is statistically significant (p < .10).8 This result suggests thatthe message acts to prime respondent support for individualism, and its subsequentinfluence on opinion concerning PAS, more effectively than the messenger, Dr. Kevorkian.The pattern of the relationship is also clearly evident in Figure 1. Interestingly, thecoefficients for religiosity additionally suggest that religiosity has more influence onrespondent PAS opinion when the messenger is Dr. Kevorkian than when the individualrights message is presented alone (p < .09). Because religious values would tend toinhibit the influence of an individual rights message, this finding suggests that the pres-ence of Dr. Kevorkian as a messenger may actually detract from the message by prim-ing values inconsistent with the frame.

Table 3 shows the analysis of respondents exposed to the pro-life frame attributed toRev. Falwell (M1) and those receiving only the pro-life frame (M2). Here the magnitude

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Table 1Influences on opposition to physician-assisted suicide

Independent variable β T value Prob.

Individual rights frame –.603 –2.365 .018(.255)

Pro-life frame .260 1.071 .285(.242)

Dr. Kevorkian as IR messenger –.588 –2.349 .019(.250)

Rev. Falwell as PL messenger .065 .258 .796(.252)

Higher education –.455 –1.447 .148(.314)

Female –.255 –1.558 .119(.163)

Non-White .842 3.517 .000(.239)

Age –.159 –.671 .502 (.237)

Ideology 1.936 6.805 .000(.284)

Religiosity 2.493 8.957 .000(.278)

Support for individual values –.698 –2.378 .018(.294)

Constant 2.420 5.918 .000(.409)

R2 .19

Adjusted R2 .18

SE 2.308

F 19.61 .000

Number of cases 962

Note. Coefficients are OLS regression coefficients. Standard errors are in parenthe-ses. Dependent variable from survey question: “How strongly do you agree or disagreewith the following statement: I would be willing to support physician-assisted suicide”(range 1 = strongly agree, 7 = strongly disagree). For comparability, all independentvariables are recoded so as to range from 0 to 1. Each frame/messenger variable iscoded one for exposure to the particular frame/messenger and zero otherwise. The con-trol group is the baseline.

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94 Mark R. Josyln and Donald P. Haider-Markel

of the religiosity coefficient is our focus. Because the pro-life frame conveys the messagewithout the potentially confounding influence of a messenger, we expected that the pro-life frame would evoke values associated with religion, and thus the coefficient forreligiosity would be larger in Model M2 than in Model M1. The results confirm thispattern. In Model M1, which includes the subset of respondents exposed to the pro-lifeframe message and the messenger (Rev. Falwell), the coefficient is smaller than in ModelM2. The difference is also statistically significant (p < .09).9 The message appears to prime

Table 2Influences on opposition to physician-assisted suicide:

Subsets of respondents exposed to individual rights message and messenger

Model M1 Model M2

Independent variable Messenger Prob. Message Prob.

Higher education –.455 .148 .486 .540(.314) (.792)

Female –.581 .121 –.604 .135(.372) (.402)

Non-White 1.294 .015 1.125 .056(.529) (.584)

Age –.879 .120 –.965 .100(.562) (.583)

Ideology 1.284 .059 2.123 .003(.675) (.698)

Religiosity 3.119 .000 2.353 .002(.607) (.742)

Support for individual values –.158 .808 –1.473 .039(.652) (.708)

Constant 1.732 .047 2.352 .008(.865) (.875)

R2 .20 .17

Adjusted R2 .17 .14

SE 2.378 2.439

F 6.68 .000 5.23 .000

Number of cases 199 184

Note. Coefficients are OLS regression coefficients. Standard errors are in parentheses. De-pendent variable from survey question: “How strongly do you agree or disagree with the follow-ing statement: I would be willing to support physician-assisted suicide” (range 1 = strongly agree,7 = strongly disagree). For comparability, all independent variables are recoded so as to rangefrom 0 to 1.

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Framing Physician-Assisted Suicide 95

respondents’ religious values, and subsequent influence on opinion concerning PAS, moreeffectively than the messenger, Rev. Falwell. For convenience, Figure 2 displays theserelationships.

Interestingly, the coefficients for the individualism variable also suggest that indi-vidualism values actually have more influence on respondent PAS opinion when themessenger is Rev. Falwell than when the pro-life message is presented alone (p < .10).Because individualism values would tend to inhibit the influence of a pro-life message,this finding also suggests that the presence of Rev. Falwell as a messenger may actuallydetract from the message.

In sum, analyses of values associated with our issue frames suggest that our PASmessengers may suppress the accessibility of the values most likely to be positivelyassociated with the specific message rather than prime them. Further, our results indicatethat the messengers might not only reduce the influence of values that would be associ-ated with the message frames, but they also appear to make it more likely that other,confounding values may come to the fore and subsequently decrease the influence ofthe message frame. We believe this occurs because our messengers, both of whom arestrongly associated with specific issue positions, provide information cues not only tothose respondents who might be predisposed to a message but also to those who mightbe predisposed in the opposite direction of the message. Such a finding is consistentwith broader work on how citizens use information cues as shortcuts for determiningtheir own issue positions (Lupia, 1994). Although these findings are intriguing, they arereally only a first step in gaining insight into the role of messengers, message, andprimed values.

Figure 1. Exposure to message and messenger, support for individualism, and opposition tophysician-assisted suicide.

1-s

up

po

rt P

AS

, 7-do

not

sup

po

rt

PA

S

Individualism Scale 0 to 3

Korkovian Frame Individualism Frame

0 1 2 3

2

3

4

5

6

Kevorkian Frame Individualism Frame

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96 Mark R. Josyln and Donald P. Haider-Markel

Conclusion

A renewed interest in the role of issue framing in political debate has led to a series ofstudies that demonstrate the important role that frames play in the distribution of publicopinion, as well as the formulation and adoption of public policy (Druckman, 2001;Haider-Markel & Joslyn, 2001; Iyengar & Kinder, 1987; Kinder & Sanders, 1990; Jacoby,2000). However, much of this literature does not account for the fact that political messagesrarely come to the public without being attributed to an individual or group. Messengers

Table 3Influences on opposition to physician-assisted suicide:

Subsets of respondents exposed to pro-life message and messenger

Model M1 Model M2

Independent variables Messenger Prob. Message Prob.

Higher education –.703 .294 –.052 .931(.669) (.609)

Female .340 .368 –.141 .647(.377) (.307)

Non-White .874 .134 .462 .300(.581) (.445)

Age .178 .335 .719 .113(.532) (.452)

Ideology 2.675 .000 2.005 .000(.565) (.566)

Religiosity 1.320 .037 2.811 .000(.627) (.519)

Support for individual values –.712 .296 –.598 .274(.679) (.545)

Constant 2.526 .002 1.722 .009(.818) (.652)

R2 .18 .24

Adjusted R2 .15 .22

SE 2.271 2.191

F 5.68 .000 10.21 .000

Number of cases 192 238

Note. Coefficients are OLS regression coefficients. Standard errors are in parentheses. De-pendent variable from survey question: “How strongly do you agree or disagree with the follow-ing statement: I would be willing to support physician-assisted suicide” (range 1 = strongly agree,7 = strongly disagree). For comparability, all independent variables are recoded so as to rangefrom 0 to 1.

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accompany messages, particularly when transmitted through the news media. Making useof original survey data of opinion on PAS we examined the opinions of respondentsexposed to issue frames on PAS, as well as those same issue frames attributed to specificpublic figures as messengers. Our results offer several conclusions.

First, even though the issue involves first principles, and one might subsequentlyexpect little room for opinions to change (Glick & Hutchinson, 2001), levels of supportfor PAS are in fact sensitive to changes in how the issue is presented. Respondentsexposed to a depiction that emphasized individual rights were more willing to supportthe use of PAS. And although the level of support given by those exposed to a frameemphasizing the value of life did not differ significantly from the control group, willing-ness to support PAS was significantly less than that expressed by respondents exposedto the individual rights frame. Thus, even for a controversial issue where one expectsopinion stability, issue frames can be a significant factor in shaping opinion.

Second, our research reaffirms the importance of issue frames in policy debate.Although frames can influence opinion, some frames may be more effective than others,and the effectiveness of each frame has implications for winners and losers in politicaldebate (Jones, 1994; Jacoby, 2000). In this case, the individual rights frame appears tobe a more effective frame for influencing opinion. And given that a slight majority ofthe public already supports PAS, it seems that use of the individualism frame may leadto successes in the policy process, all other things being equal.

Third, by comparing groups of respondents exposed to a message, a messenger andmessage, and a control group not exposed to any of the above, our analysis suggeststhat messengers do not always enhance the message and may even serve to neutralize or

1-s

upport

PA

S, 7-d

o n

ot

support

PA

S

Importance of Religion in Life 1-not important

Falwell Frame Life Frame

1 2 3 4 5 6 7

2

3

4

5

6

Figure 2. Exposure to message and messenger, religiosity, and opposition to physician-assistedsuicide.

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98 Mark R. Josyln and Donald P. Haider-Markel

detract from it. Indeed, our analysis of the role of respondent values that might beprimed by the messages suggests that the presence of a messenger may weaken thepriming of those values, subsequently reducing the impact of the message on opinion. Inparticular, the use of Dr. Kevorkian as a messenger of an individual rights frame re-duced the influence of individual values on opinion toward allowing PAS. Meanwhile,the use of Rev. Falwell as a messenger of a pro-life frame reduced the influence ofreligiosity on opinion toward allowing PAS. And in the case of Dr. Kevorkian as mes-senger, religiosity appears to have been primed, while in the case of Rev. Falwell, indi-vidual values appear to have been primed. Though speculative, and based on two verycontroversial messengers, messengers are significant factors in framing issues and mayin fact enhance or impede the priming of important beliefs that shape opinion on theissue. We acknowledge that less controversial public figures may influence opinion indifferent ways, and we cannot generalize to those cases. However, we encourage furtherresearch to explore this question.

Fourth, we argued that examinations of the role of messengers versus the messageneed to identify and make use of well-known public figures who can be credibly linkedto specific issues and specific issue positions. However, this requirement may make itdifficult to make broad generalizations concerning the influence of messengers on publicopinion. Because our study is intended to be an early first step, future researchers in thisarea should design experiments that can test our underlying assumptions and determinealternative strategies for testing the influence of messengers and message on opinion.

Finally, although more research is needed comparing the role of message and mes-senger across a diverse set of issues, and using a larger variety of messengers, ourfindings do point to a conundrum for issue advocates as well as researchers. In today’smedia environment, groups wishing to gain support for an issue require a face, a publicpersona that provides a convenient, and some might argue a necessary, point of depar-ture from which citizens can access and learn more about the issue. However, somefaces may prove more helpful to the cause than others, and very few political figuresenjoy widespread popularity. For PAS, where neither messenger appears effective, andindeed ineffective, in priming relevant opinion considerations, advocacy coalitions mayhave more success when they simply sell their message devoid of a messenger or per-haps have it delivered by a less well-known or less controversial political messenger.10

Perhaps the most effective example of this point was the “Harry and Louise” tele-vision ads run against President Clinton’s national health care proposal in 1993. Harryand Louise purportedly represented everyday people, but they also were not recogniz-able public figures with political baggage. The message prevailed at least in part be-cause the messengers did not overwhelm or muddle it. Citizens confronted the com-plexities of health care reform through a neutral and comfortable as opposed to a con-troversial political source, activating the considerations emphasized in the message. Messengerswho are public figures can of course be persuasive, for example in the endorsement ofcommercial products, or, in the case of Magic Johnson, on the behaviors associated withcontracting AIDS (Pollock, 1994), but it seems less likely that messengers who are alsopolitical figures can effectively convey a message without alienating some even whilethey maintain or gain the support of others.

Notes

1. This discussion further makes it clear that the choice of messenger might determine therelative influence of message versus messenger, but also that the relative influence of a messenger

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would vary by respondent. This particular aspect of the influence of messengers is broader thanwhat we can address here simply because we must first identify messengers that would likely beassociated with specific messages, or points of view. After taking this step, future research couldmore clearly identify specific messengers associated with an issue, respondent predispositions tothese messengers, and the extent to which the messengers are controversial or are viewed asobjective authorities on given topics.

2. The other direct legislation proposals on PAS were held in Washington (1991), Califor-nia (1992), Oregon (1994), Michigan (1998), and Maine (2000).

3. Survey data are from the Howard W. Odum Institute for Research in Social Science atthe University of North Carolina, Chapel Hill (http://www.irss.unc.edu).

4. Potential adult respondents were randomized within households by asking for the adultin the household who had the most recent birthday. When no contact was made, at least threeattempts were made to contact each household at varying times and days. The maximum numberof attempts at contact was 10.

5. The individualism scale for each respondent ranges from zero to three and was com-puted by adding the scores for the following questions together: “Which one is closer to yourown view. (a) The less government the better (1) or There are more things that governmentshould be doing (0); (b) The main reason that government has gotten bigger over the years isbecause it has gotten involved in things that people should do for themselves (1) or Governmenthas gotten bigger because the problems we face have gotten bigger (0); and (c) The governmentshould try to ensure that all Americans have such things as jobs, health care, and housing (0)or The government should not be involved in this (1). The questions are based on Feldman(1999).

6. Although the group exposed to the pro-life frame did not respond in a manner signifi-cantly different from the control group, their responses were significantly different from thoseexposed to the individual rights frame. This finding is important considering that nearly all of theresearch on framing simply compares groups exposed to different issue frames rather than com-paring those exposed to individuals in a control group who have not been exposed to any type offrame.

7. We also estimated interactions in the full data set using OLS models and obtainedresults that converged with those reported in Tables 2 and 3.

8. The coefficients for the model using the full data set and testing the individualisminteraction term were as follows: education –.048 (p = .928); female –.591 (p = .029); non-White1.181 (p = .003); age, –.937 (p = .020); ideology, 1.689 (p = .000); religiosity, 2.805 (p = .000);support for individualism values, –.462 (p = .043); Kevorkian as messenger, –.914 (p = .129);interaction between Kevorkian and individualism, .487 (p = .099); N = 383; R 2 = .18.

9. The coefficients for the model using the full data set and testing the religiosity inter-action term are as follows: education, –.412 (p = .358); female, .098 (p = .680); non-White, .656(p = .063); age, .423 (p = .216); ideology, 2.389 (p = .000); religiosity, 2.664 (p = .000); supportfor individualism values, –.222 (p = .116); Falwell as messenger, .663 (p = .249); interactionbetween Falwell and religiosity, –1.216 (p = .089); N = 430; R 2 = .20.

10. It should also be clear that activists are not always, and perhaps rarely, able to shapewho becomes the messenger for a cause, especially in the diverse media environment of theUnited States.

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AppendixDescriptive Statistics for PAS Issue Framing Survey

Number %

Ideology7 Strong conservative 185 16.86 Somewhat strong conservative 77 7.15 Weak conservative 289 26.34 Moderate 202 18.43 Weak liberal 243 22.12 Somewhat strong liberal 38 3.51 Strong liberal 65 5.9

Gender0 Male 439 36.61 Female 760 63.4

Education1 Less than 9th grade 9 0.82 Some high school 43 3.73 High school or GED 269 23.24 Some college 330 28.55 Two-year degree 121 10.46 Four-year degree 218 18.87 Some graduate school 42 3.68 Graduate degree 127 11.0

Race0 White 1011 88.11 Non-White 137 11.9

Religiosity7 A great deal 473 40.26 175 14.95 161 13.74 97 8.23 132 11.22 90 7.61 None at all 50 4.2

Prayer7 Every day 583 49.66 125 10.65 141 12.04 90 7.73 88 7.52 77 6.61 Never 72 6.1

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Number %

Individualism scale (3-question additive index)0 Least individualistic 43 3.81 395 35.12 488 43.43 Most individualistic 199 17.7

Respondent frame exposure and groupingsControl group 203 16.8Pro-life frame 301 24.9Individual rights frame 230 19.1Falwell/pro-life frame 236 19.6Kevorkian/individual rights 237 19.6

Total number of cases 1,207

Note. The survey was a random sample telephone survey of adultsconducted during spring 1999. The median age was 45 years. Religiositywas based on the question “How much guidance does religion provide inyour life.” Prayer was based on the question “How often do you pray?”For the analysis, these questions were combined and the average score wasused for each respondent. The individualism scale was based on three questionsdescribed in the text.

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