Hart L Gary, Norris Thomas E, Lishner Denise M
Department of Family Medicine, University of Washington, Box 354696, Seattle, WA 98195-4696, USA.
J Rural Health. 2003 Fall;19(4):461-9. doi: 10.1111/j.1748-0361.2003.tb00583.x.
The topic of physician-assisted suicide is difficult and controversial. With recent laws allowing physicians to assist in a terminally ill patient's suicide under certain circumstances, the debate concerning the appropriate and ethical role for physicians has intensified.
This paper utilizes data from a 1997 survey of family physicians (FPs) in Washington State to test two hypotheses: (1) older respondents will indicate greater opposition to physician-assisted suicide than their younger colleagues, and (2) male and rural physicians will have more negative attitudes toward physician-assisted suicide than their female and urban counterparts.
A questionnaire administered to all active FPs obtained a 68% response rate, with 1074 respondents found to be eligible in this study. A ZIP code system based on generalist Health Service Areas was used to designate those practicing in rural versus urban areas.
One-fourth of the respondents overall indicated support for physician-assisted suicide. When asked whether this practice should be legalized, 39% said yes, 44% said no, and 18% indicated that they did not know. Fifty-eight percent of the study sample reported that they would not include physician-assisted suicide in their practices even if it were legal. Responses disaggregated by age-groups closely paralleled the group overall. There was a significant pattern of opposition on the part of rural male respondents compared to urban female respondents. Even among those reporting support for physician-assisted suicide, many expressed reluctance about including it in their practices.
These findings highlight the systematic differences in FP attitudes toward one aspect of health care by gender, rural-urban practice location, and other factors.
医生协助自杀这一话题既棘手又存在争议。随着近期法律允许医生在某些情况下协助绝症患者自杀，有关医生恰当且符合伦理的角色的辩论愈演愈烈。
本文利用1997年华盛顿州家庭医生调查的数据来检验两个假设：（1）年长的受访者相较于年轻的同行会表现出更强烈地反对医生协助自杀，以及（2）男性和乡村医生对医生协助自杀的态度会比女性和城市医生更为消极。
对所有在职家庭医生进行问卷调查，回复率为68%，本研究中发现1074名受访者符合条件。基于全科医生健康服务区的邮政编码系统被用来划分在农村和城市地区执业的医生。
总体而言，四分之一的受访者表示支持医生协助自杀。当被问及这种做法是否应合法化时，39%的人表示赞同，44%的人表示反对，18%的人表示不知道。58%的研究样本报告称，即使医生协助自杀合法化，他们也不会在自己的执业中采用。按年龄组划分的回复与总体情况非常相似。与城市女性受访者相比，农村男性受访者存在显著的反对模式。即使在那些表示支持医生协助自杀的人中，许多人也对在自己的执业中采用这种做法表示不情愿。
这些发现凸显了家庭医生在医疗保健的一个方面，因性别、城乡执业地点及其他因素而产生的系统性态度差异。
