医学生与医务人员对安乐死的认识和评价调查

采用问郑调查方法调查了４０１名医学生与医务人员对安乐死的认识与接受程度。结果 赞成安乐死的占９０．７７％,其主要理由是认为安乐死是人道的,可以帮助患者及其家属解脱痛苦。认为最佳安尔死方式的,有３２．０３％造反主动安乐死,只有１８．１３％选择被动安乐死。６６．２９％的安尔死造成者对于安乐死的态度存在理智上与感情上的矛盾心理。法制不健全和传统习俗的影响被认为是安乐死的所面临的两大障碍。     

不同人群对安乐死态度及现状的调查

目的：调查中小城市不同人群对安乐死及其现状的态度,了解公众对安乐死的认同度以及安乐死在我国实施的合理性和可能性,发现我国安乐死合法化进程中遇到的主要困难并提出建议。方法：采用自制问卷,在当地社区进行问卷的发放和回收,发放问卷210份,共回收有效问卷202份,回收率为96.2％。结果：市民对于安乐死问题了解不足,仅有36％的被调查者表示对安乐死问题有了解,有75％的人赞同在我国实施安乐死,被调查的11名医生全部赞成在我国实施安乐死;有宗教信仰的人对安乐死的认同度较低;文化程度越高,越能意识到解决安乐死问题立法是关键。结论：中小城市市民对于安乐死问题了解偏少,不同人群对其在我国实施的合理性及主要困难认识存在差异,这在社会上引起了广泛争议,阻滞了我国安乐死合法化的进程。为推动安乐死在我国实施,有必要加强对市民的宣传教育,改革我国教育体制,推动安乐死立法工作进行,为我国的安乐死合法化提供保障。     

从香港允许病人“被动安乐死”所引发的关于安乐死立法的思考

20 0 0年 1月 19日《健康报》刊载 :香港特别行政区医务委员会决定 :从 2月开始 ,允许医生对无法挽回意识、纯粹依赖医疗仪器维持生理机能的病人停止治疗 ,即被动安乐死。但规定强调 ,这样做必须有足够的理由 ,在医生、病人家属和医院院长一致同意下 ,方可实施。读后 ,无比兴奋 ,深深感到 :虽然这个决定不是法规 ,只是一个地区的组织的行政措施 ,但毕竟是中国在安乐死问题上的一个积极举措。它进一步引发我们对安乐死立法的思考 :安乐死必须立法 ,这是大势所趋 ,不可抗拒。因此 ,对待安乐死立法 ,应该采取积极态度。但安乐死立法关系着人的…     

全科医师骨干对安乐死的认知、态度及意向的调查分析

目的：了解全科医师骨干对安乐死的认知、态度及意向情况。方法：应用自行设计的问卷对广东省全科医师骨干培韧1班的164名学员进行现场自填式问卷调查。结果：96．9％的被调查者对安乐死有一定了解;51．8％的被调查者赞成安乐死,不同专业的被调查者对安乐死的态度具有显著性差异（P〈0．05）;50％的被调查者赞成安乐死合法化,相对于西医专业,中医专业的被调查者更倾向于赞成安乐死合法化,学历越高者越倾向于赞成安乐死合法化（P〈0．05）;有28．7％的被调查者表示愿意为病人实施安乐死。结论：被调查的全科医师骨干安乐死总体知晓率较高,但多数人对实施安乐死和安乐死合法化持谨慎态度。全科医生应在现代医学伦理观的指导下积极开展临终关怀照顾,为我国安乐死的立法和长远发展积累实践依据。     

大学生对“有严重缺陷新生儿施行安乐死”看法的调查研究

通过对1028名大学生问卷们查,结果显示:80％以上的学生认为对有严重缺陷新生儿行安乐死这一做法是可行的;77％的学生认为在不久的将来能被社会接受;94％的学生认为对该做法应有立法监督;95％以上的学生认为婚前检查与产前检查是非常必要的;就读的专业、性别及来源地是影响大学生对有严重缺陷新生儿实行安乐死的各方面看法的主要因素.     

医院护士安乐死观念与年龄及从事护理工作时间的相关分析

尽管我国并未从法律上确认安乐死的合法性,但安乐死特别是被动安乐死却一直以不同的形式在悄悄地进行。作者对所在医院522名在岗护士进行了安乐死观念的调查大部分护士均了解并赞同安乐死。但不同年龄及从事护理工作时间的长短影响着护士的安乐死观念。报告如下:1　调查对...     

福建省安乐死民意初探

为了探讨福建省居民及身患绝症病人对安乐死的承受心理和接受程度,以问卷调查的方法,对福州市561名学生、干部、医护人员、恶性肿瘤病人进行民意测验.结果发现,多数人对安乐死是可以接受的.同时还发现,对安乐死的态度还受年龄、职业、身体健康状况等因素的影响.建议加强宣传,进行“优死”教育.     

国际

瑞士：支持保留安乐死 瑞士苏黎世最近投票拒绝了对安乐死和“安乐死旅游”设置禁令。此次投票共有278,000人参加,其中85％的人反对对安乐死设置禁令,78％的人反对禁止外国人来瑞士进行安乐死。     

肿瘤病人直系亲属对安乐死态度及意向的调查

通过对住院肿瘤病人直系亲属陪护者对安乐死态度及意向的调查,发现:陪护亲属赞成对患病亲人实施安乐者占17.9%,低年龄、男性、非农民职业、城市居民、文化程度较高及认为病人病情较重者赞成安乐死的比例较高.SCL—90评定结果.赞成安乐死组各因子分均高于不赞成组.结果表明:在我国实施安乐死及有关安乐死立法问题条件尚不成热.     

浅析安乐死

安乐死是社会发展进程中所面临的一个不可避免的问题,自20世纪80年代以来,安乐死的讨论、调查、研究逐步深入,通过有关安乐死文献进行检索、分析,多数文献赞成或支持施行安乐死,其中不乏有赞成安乐死的同时又反对安乐死立法。从安乐死的定义可以认识到,它是一种死亡状态,     

护理大专生对安乐死的态度及意向调查分析

目的 了解护理大专生对安乐死的态度及意向情况,为护理伦理教育提供参考依据.方法 采用自行设计的问卷对长沙市某职业学院的护理大专三年级全体学生共350人进行现场自填式问卷调查.结果 350名护理大专生中,64.9%的学生赞同安乐死,70%的护生表示如果自己患不治之症愿意选择安乐死,如果亲人要求安乐死,45.1%的护生会同意,绝大部分护生认为安乐死应该合法化.而对于对濒临死亡患者实施主动安乐死和被动安乐死的回答,持反对态度者（44.3%和64.8%）均多于持赞同态度者（31.1%和13.7%）.男女生在是否同意亲人安乐死方面存在差异（P〈0.05）,不同家庭住址的学生在是否支持亲人安乐死、是否赞同主动安乐死和被动安乐死方面存在差异（均P〈0.05）,而是否学习过〈护理伦理学〉课程的学生除了在是否支持亲人安乐死方面无差异外,其他方面均有差异（均P〈0.05）.结论 绝大多数护理大专生支持安乐死,且对安乐死意向较明确.应加强对其护理伦理学的教学,积极正确引导护生,使护生对安乐死有科学的认识.     

医学生对安乐死的认知和态度调查

目的:调查医学生对安乐死的认知和态度,并分析可能的影响因素,为医学伦理教育提供参考依据.方法:采用自行设计的问卷对某医学院校526名本科生进行关于安乐死认知和态度方面的调查.结果:526名被调查者中,安乐死知晓率为63.9%,被调查者表示对安乐死有所了解,但了解的内容和范围有限,94.3%的被调查者认为生命权属于个人,但对于个人是否有权利决定自己生死则表现得较为矛盾.被调查者均承认安乐死属于跨学科、跨领域的争议性问题,63.9%赞成安乐死,63.5%表示安乐死在我国立法是非常必要的.58.7%表示在本人面临是否选择安乐死时要视具体情况而定,64.6%的被调查者在面对亲人选择安乐死时表示不会主动建议,但会支持其决定.结论:多数调查者对安乐死有一定的了解,但是受我国传统思想观念的影响,医学生对于死亡和安乐死的认识有限,被调查者对实施安乐死态度较为严谨,应加强医学生伦理教育和死亡教育,正确引导医学生认识死亡,正确看待安乐死.     

Attitudes of medical students towards euthanasia in a multicultural setting

A cross-sectional survey of 400 medical students of multicultural backgrounds at the University of Malaya was conducted to understand their attitudes towards euthanasia and factors related to medical decisions and ethical reasoning concerning the prolongation of life, the right to die and euthanasia. The student respondents completed self-administered questionnaires that comprised of twelve questions with multiple stems addressing personal perceptions, knowledge, attitudes, and decisions about euthanasia and the relief of suffering. The majority of respondents (52%) were for the withdrawal of active therapy in a patient suffering from a terminal painful disease while 48% of them were against it. Seventy-one percent of the students involved in the study were against the idea of active euthanasia i.e. the administration of a lethal injection. However, 27% of the respondents felt that there was a moral justification to assist patients to die. Thirty-two percent of the respondents favoured the legalization of euthanasia in Malaysia while 67% of them were strongly against it. The majority (61%) of respondents would not practice euthanasia as a doctor nor would they have performed on themselves if or when it became legal. The main issue surrounding euthanasia that concerned the respondents was the misuse of it by unethical practitioners and they felt that further debate on the matter was essential, both within the local and international communities.     

Passive euthanasia

The idea of passive euthanasia has recently been attacked in a particularly clear and explicit way by an "Ethics Task Force" established by the European Association of Palliative Care (EAPC) in February 2001. It claims that the expression "passive euthanasia" is a contradiction in terms and hence that there can be no such thing. This paper critically assesses the main arguments for the Task Force's view. Three arguments are considered. Firstly, an argument based on the (supposed) wrongness of euthanasia and the (supposed) permissibility of what is often called passive euthanasia. Secondly, the claim that passive euthanasia (so-called) cannot really be euthanasia because it does not cause death. And finally, a consequence based argument which appeals to the (alleged) bad consequences of accepting the category of passive euthanasia.We conclude that although healthcare professionals' nervousness about the concept of passive euthanasia is understandable, there is really no reason to abandon the category provided that it is properly and narrowly understand and provided that "euthanasia reasons" for withdrawing or withholding life-prolonging treatment are carefully distinguished from other reasons.     

Abortion and euthanasia of Down''s syndrome children--the parents'' view.

A study of 78 parents of Down's syndrome children shows that, while most were in favour of abortion for a handicapped fetus, they were divided equally on whether euthanasia (no distinction made between active and passive euthanasia) was an acceptable practice. Only a third considered an average Down's syndrome child could be a suitable candidate for euthanasia. While parents argued that the degree of handicap of the child was the crucial factor in making this decision, in fact the social class of the parents themselves was the only variable which was statistically significantly related to their opinions. Differences arose from the parents' lack of agreement on what constituted a sufficiently severe handicap.     

大学新生自杀意念及其影响因素的现况调查

目的：探讨有自杀意念的大学新生的自杀态度等影响因素及其与自杀意念的关系。方法：采用自杀态度问卷、自尊量表、简易应对方式问卷、社会支持量表、自评抑郁量表、焦虑自评量表对广西医科大学2009级500名新生进行调查。结果：自杀意念检出率为29.07%,大学新生对自杀的性质、对安乐死的态度持矛盾或中立的态度（〉2.5分-〈3.5分）,对自杀者的态度、对自杀者家属的态度持肯定和宽容的态度（≤2.5分）。有自杀意念的大学新生对自杀的性质、对安乐死的态度倾向于认可和宽容,而对自杀者家属的态度则倾向于否认和排斥,个体的自尊水平较高。有自杀意念的大学新生获得的总社会支持、主观社会支持、客观社会支持较少,对社会支持的利用度较低,表现出更多的抑郁焦虑情绪,较多采用消极的应付方式,Logistic回归分析表明抑郁、消极应付方式、社会支持总分3个指标对自杀意念的影响有统计学差异（P=0.001,0.014,-0.020）。结论：抑郁、消极应付方式、社会支持总分是影响大学新生自杀意念的重要因素。     

Attitudes of Finnish doctors towards euthanasia in 1993 and 2003

Questionnaire studies on the attitudes of Finnish doctors towards euthanasia were conducted in 1993 and 2003, and the results show that they have not become more positive.The attitudes of doctors towards active euthanasia are, in general, more negative than the attitudes of the general public. The interpretations of surveys are, however, highly dependent on the formulation of the questions and, although the questions posed to these groups are similar, it is probable that the interpretations of doctors differ from those of the general public.According to most studies, most doctors, except those from The Netherlands, are against legalisation on active euthanasia. Considerable variation exists in the percentage of doctors opposing the practice. The variation is, of course, partly because of the variation in opinion, but several methodological issues also explain it. Some studies have asked direct questions about the legalisation of euthanasia—for example, in others, the questions have been about the ethical acceptance of the practice. Some studies have used case vignettes, whereas others have used general questionnaires. The knowledge and availability of palliative care may also affect the answers.¹The definition of euthanasia is of particular importance in the studies. The distinction between passive euthanasia (ie, withholding or withdrawing life‐saving treatment) and active euthanasia (ie, deliberately terminating the life of the patient with a lethal drug, for example,) has not always been clear.Although numerous studies with different methods have focused on the attitudes of doctors towards euthanasia and other practices at the end of life, we lack knowledge on possible changes in these attitudes. Legal changes in The Netherlands and Belgium, and open public discussion on these issues, most recently in the Council of Europe (http://assembly.coe.int/Documents/WorkingDocs/Doc03/EDOC9898.htm), may lead us to think that the attitudes of doctors have also become more positive. This study determined whether such a change had taken place in Finland.     

Attitudes and desires related to euthanasia and physician-assisted suicide among terminally ill patients and their caregivers

CONTEXT: Euthanasia and physician-assisted suicide (PAS) are highly controversial issues. While there are studies of seriously ill patients' interest in euthanasia and PAS, there are no data on the attitudes and desires of terminally ill patients regarding these issues. OBJECTIVE: To determine the attitudes of terminally ill patients toward euthanasia and PAS, whether they seriously were considering euthanasia and PAS for themselves, the stability of their desires, factors associated with their desires, and the proportion of patients who die from these interventions. DESIGN: Prospective cohort of terminally ill patients and their primary caregivers surveyed twice between March 1996 and July 1997. SETTING: Outpatient settings in 5 randomly selected metropolitan statistical areas and 1 rural county. PARTICIPANTS: A total of 988 patients identified by their physicians to be terminally ill with any disease except for human immunodeficiency virus infection (response rate, 87. 4%) and 893 patient-designated primary caregivers (response rate, 97. 6%). MAIN OUTCOME MEASURES: Support for euthanasia or PAS in standard scenarios; patient-expressed considerations and discussions of their desire for euthanasia or PAS; hoarding of drugs for suicide; patient death by euthanasia or PAS; and patient-reported sociodemographic factors and symptoms related to these outcomes. RESULTS: Of the 988 terminally ill patients, a total of 60.2% supported euthanasia or PAS in a hypothetical situation, but only 10. 6% reported seriously considering euthanasia or PAS for themselves. Factors associated with being less likely to consider euthanasia or PAS were feeling appreciated (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.52-0.82), being aged 65 years or older (OR, 0.52; 95% CI, 0.34-0.82), and being African American (OR, 0.39; 95% CI, 0. 18-0.84). Factors associated with being more likely to consider euthanasia or PAS were depressive symptoms (OR, 1.25; 95% CI, 1.05-1. 49), substantial caregiving needs (OR, 1.09; 95% CI, 1.01-1.17), and pain (OR, 1.26; 95% CI, 1.02-1.56). At the follow-up interview, half of the terminally ill patients who had considered euthanasia or PAS for themselves changed their minds, while an almost equal number began considering these interventions. Patients with depressive symptoms (OR, 5.29; 95% CI, 1.21-23.2) and dyspnea (OR, 1.68; 95% CI, 1.26-2.22) were more likely to change their minds to consider euthanasia or PAS. According to the caregivers of the 256 decedents, 14 patients (5.6%) had discussed asking the physician for euthanasia or PAS and 6 (2.5%) had hoarded drugs. Ultimately, of the 256 decedents, 1 (0.4%) died by euthanasia or PAS, 1 unsuccessfully attempted suicide, and 1 repeatedly requested for her life to be ended but the family and physicians refused. CONCLUSIONS: In this survey, a small proportion of terminally ill patients seriously considered euthanasia or PAS for themselves. Over a few months, half the patients changed their minds. Patients with depressive symptoms were more likely to change their minds about desiring euthanasia or PAS. JAMA. 2000;284:2460-2468.