Health Care Professionals' Attitudes About Physician-Assisted Death: An Analysis of Their Justifications and the Roles of Terminology and Patient Competency

• Published in: Journal of pain and symptom management 2017-10, Vol.54 (4), p.538-545.e3
• Main Authors: Braverman, Derek W., Marcus, Brian S., Wakim, Paul G., Mercurio, Mark R., Kopf, Gary S.
• Format: Article
• Language: English
• Subjects: Adult; Advance directives; Analysis of Variance; assisted death; Assisted suicide; Attitude of Health Personnel; Attitudes; Bias; cancer; Competence; Death & dying; Euthanasia; Female; Health Personnel - psychology; Humans; Informed consent; Killing; Legalization; Logistic Models; Male; Medical ethics; Medical personnel; Mental Competency; Mercy; Middle Aged; Palliative care; Patient satisfaction; Patient-centered care; Patients; Patients rights; Professional attitudes; Questionnaires; Right to die; Suffering; Suicide, Assisted - ethics; Suicide, Assisted - psychology; Suicides & suicide attempts; survey; Surveys and Questionnaires; Terminology; Terminology as Topic; Thinking
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2017.07.024

Health care professionals (HCPs) are crucial to physician-assisted death (PAD) provision. 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. 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, nonphysician clinicians, and other nonclinical staff at a major academic medical center. Of 221 HCPs, the majority thought that 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, nonabandonment, and saving money for the health care system; opposing justifications were the slippery slope argument, unnecessary due to palliative care, killing patients is wrong, religious views, and suicide is wrong. The use of suicide and euthanasia terminology did not affect responses. Participants preferred physician-assisted suicide to euthanasia for a competent patient (P