Healthcare professionals' attitudes about physician-assisted death : an analysis of their justifications and the roles of terminology and patient competency

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BRAVERMAN, Derek W. | MARCUS, Brian S. | WAKIM, Paul G. | MERCURIO, Mark R. | KOPF, Gary S.

CONTEXT: Healthcare professionals (HCPs) are crucial to physician-assisted death (PAD) provision. OBJECTIVES: To quantitatively assess the favorability of justifications for or against PAD legalization among HCPs, the effect of the terms "suicide" and "euthanasia" on their views, and their support for three forms of PAD. METHODS: Our questionnaire presented three cases: physician-assisted suicide, euthanasia for a competent patient, and euthanasia for an incompetent patient with an advance directive for euthanasia. Respondents judged whether each case was ethical and should be legal, and selected their justifications from commonly cited reasons. The sample included physician clinicians, researchers, non-physician clinicians, and other non-clinical staff at a major academic medical center. RESULTS: Of 221 HCPs, the majority thought each case was ethical and should be legal. In order of declining favorability, justifications supporting PAD legalization were relief of suffering, right to die, mercy, acceptance of death, non-abandonment, and saving money for the healthcare system; opposing justifications were the slippery slope argument, unnecessary due to palliative care, killing patients is wrong, religious views, and suicide is wrong. Use of suicide and euthanasia terminology did not affect responses. Participants preferred physician-assisted suicide to euthanasia for a competent patient (p<0.0001) and euthanasia for an incompetent patient to euthanasia for a competent patient (p<0.005). CONCLUSIONS: HCPs endorsed patient-centered justifications over other reasons, including role-specific duties. Suicide and euthanasia language did not bias HCPs against PAD, challenging claims that such value-laden terms hinder dialogue. More research is required to understand the significance of competency in shaping attitudes toward PAD.

http://dx.doi.org/10.1016/j.jpainsymman.2017.07.024

Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 54»

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