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.     

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 of Ontario psychiatrists towards health insurance.

In 1979 the opinions of Ontario psychiatrists were sought regarding the influence of the Ontario Health Insurance Plan (OHIP) on the practice of their specialty. Full replies to a 44-item questionnaire were received from more than half the certified psychiatrists in Ontario, half of whom had been in practice before the introduction of OHIP. Both satisfaction and uneasiness were expressed about most aspects of health insurance. Many of the 416 psychiatrists stated that OHIP had improved access to psychiatric care, providing a more socially diverse practice, especially with respect to psychotherapy. Only one quarter believed that OHIP constituted a major intrusion on the doctor-patient relationship, and the majority reported that OHIP had been beneficial to themselves as psychiatrists (70%) and to their patients (86%). Almost half reported having raised their concern about the confidentiality of OHIP records with their patients; the patients less often brought up the issue. Although most psychiatrists in practice before the introduction of OHIP reported no change in their conduct of psychotherapy, a minority reported a decrease in the duration of treatment and an increase in the frequency of missed appointments. Also noted was an increase in the number of referrals for consultation, which led at times to overutilization of these specialists' services.     

Surveys on attitudes towards legalisation of euthanasia: importance of question phrasing

AIM: To explore whether the phrasing of the questions and the response alternatives would influence the answers to questions about legalisation of euthanasia. METHODS: Results were compared from two different surveys in populations with similar characteristics. The alternatives "positive", "negative", and "don't know" (first questionnaire) were replaced with an explanatory text, "no legal sanction", four types of legal sanctions, and no possibility to answer "don't know" (second questionnaire). Four undergraduate student groups (engineering, law, medicine, and nursing) answered. RESULTS: In the first questionnaire (n = 684) 43% accepted euthanasia (range 28-50%), 14% (8-33%) did not, and 43% (39-59%) answered "don't know". Two per cent of the respondents declined to answer. In comparison with previous surveys on attitudes to euthanasia the proportion of "don't know" was large. The results of the second questionnaire (n = 639), showed that 38% favoured "no legal prosecution" (26-50%). However, 62% (50-74%) opted for different kinds of legal sanctions, and two of four groups expressed significantly different views in the two surveys. A proportion of 10% declined to answer the second questionnaire. CONCLUSION: An introduction of an explanatory text and a wider range of response alternatives produced differences between the results of the two surveys conducted.     

不同人群对安乐死的认同态度调查分析

目的：了解本地区不同人群对安乐死的认同态度。方法：选取三种不同人群（即癌肿患者及其主要家属，以及近年无主要亲属患癌症的健康人群）分别作为A、B、C组，A组123例，B组139例，C组140例，根据不同情况A组采用间接问卷，B、C两组采用直接问卷。问卷内容包括：①对安乐死认同与否；②认同与不认同的理由。结果：A、B、C三组不同人群认同率比较有显著差异（P＜0．05），A与B、A与C分别比较也均有差异（P＜0．05），且认同率与人群文化程度呈正相关，三组认同理由无差异。结论：安乐死作为一种特别的临终处理，虽然目前的实施有多种障碍，但正在被愈来愈多的人所理解接受。     

大连市部分地区农村人群的自杀态度分析

目的 研究中国农村人群的自杀态度.方法 采取序贯抽样的方法,采集了2000年度、2001年度大连市金州和庄河两地区66个自杀死亡病例的132个信息人和66个正常对照本人及其132个信息人.用自杀态度问卷了解病例组信息人和对照组本人及其信息人对自杀的态度,然后运用SPSS11.5进行数据整理与分析.结果 自杀组信息人对自杀总的理解程度以及对不同性别自杀者的理解程度[评分平均秩次分别为总理解程度121.57,对男性自杀者理解程度121.41,对女性自杀者理解程度121.53],均低于对照组信息人[对应的评分平均秩次分别为143.43,143.59,143.47,差异具有显著性.Z值、P值分别为(-2.628,0.009),(-2.681,0.007),(-2.624,0.009)].信息人对女性自杀者的理解和宽容程度高于对男性自杀者(Z ＝-2.565,P ＝0.010),男性信息人更倾向于理解和接受女性自杀(Z ＝-2.060,P ＝0.039).结论 该地区农村人群总体上对自杀持不接受态度,但是对女性自杀比对男性自杀更加认可和宽容.此发现可能有助于解释中国女性较高的自杀率.     

大连市部分地区农村人群的自杀态度分析

目的研究中国农村人群的自杀态度。方法采取序贯抽样的方法,采集了2000年度、2001年度大连市金州和庄河两地区66个自杀死亡病例的132个信息人和66个正常对照本人及其132个信息人。用自杀态度问卷了解病例组信息人和对照组本人及其信息人对自杀的态度,然后运用SPSS11.5进行数据整理与分析。结果自杀组信息人对自杀总的理解程度以及对不同性别自杀者的理解程度[评分平均秩次分别为总理解程度121.57,对男性自杀者理解程度121.41,对女性自杀者理解程度121.53],均低于对照组信息人[对应的评分平均秩次分别为143.43,143.59,143.47,差异具有显著性。Z值、P值分别为(-2.628,0.009),(-2.681,0.007),(-2.624,0.009)]。信息人对女性自杀者的理解和宽容程度高于对男性自杀者(Z=-2.565,P=0.010),男性信息人更倾向于理解和接受女性自杀(Z=-2.060,P=0.039)。结论该地区农村人群总体上对自杀持不接受态度,但是对女性自杀比对男性自杀更加认可和宽容。此发现可能有助于解释中国女性较高的自杀率。