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医生协助自杀或安乐死在何时是可以接受的?

When is physician assisted suicide or euthanasia acceptable?

作者信息

Frileux S, Lelièvre C, Muñoz Sastre M T, Mullet E, Sorum P C

机构信息

Centre for Research in Psychopathology, Mirail University, Toulouse, France.

出版信息

J Med Ethics. 2003 Dec;29(6):330-6. doi: 10.1136/jme.29.6.330.

Abstract

OBJECTIVES

To discover what factors affect lay people's judgments of the acceptability of physician assisted suicide and euthanasia and how these factors interact.

DESIGN

Participants rated the acceptability of either physician assisted suicide or euthanasia for 72 patient vignettes with a five factor design--that is, all combinations of patient's age (three levels); curability of illness (two levels); degree of suffering (two levels); patient's mental status (two levels), and extent of patient's requests for the procedure (three levels).

PARTICIPANTS

Convenience sample of 66 young adults, 62 middle aged adults, and 66 older adults living in western France.

MAIN MEASUREMENTS

In accordance with the functional theory of cognition of N H Anderson, main effects, and interactions among patient factors and participants' characteristics were investigated by means of both graphs and ANOVA.

RESULTS

Patient requests were the most potent determinant of acceptability. Euthanasia was generally less acceptable than physician assisted suicide, but this difference disappeared when requests were repetitive. As their own age increased, participants placed more weight on patient age as a criterion of acceptability.

CONCLUSIONS

People's judgments concur with legislation to require a repetition of patients' requests for a life ending act. Younger people, who frequently are decision makers for elderly relatives, place less emphasis on patient's age itself than do older people.

摘要

目的

探究哪些因素会影响外行人对医生协助自杀和安乐死可接受性的判断,以及这些因素如何相互作用。

设计

参与者采用五因素设计对72个患者案例中的医生协助自杀或安乐死的可接受性进行评分,即患者年龄(三个水平)、疾病可治愈性(两个水平)、痛苦程度(两个水平)、患者精神状态(两个水平)以及患者对该程序的请求程度(三个水平)的所有组合。

参与者

来自法国西部的66名年轻人、62名中年人和66名老年人的便利样本。

主要测量指标

根据N·H·安德森的认知功能理论,通过图表和方差分析研究患者因素与参与者特征之间的主效应和相互作用。

结果

患者的请求是可接受性最有力的决定因素。安乐死通常比医生协助自杀更难被接受,但当请求重复时,这种差异就消失了。随着自身年龄的增长,参与者更看重患者年龄作为可接受性的标准。

结论

人们的判断与要求患者重复对结束生命行为的请求的立法一致。经常为老年亲属做决策的年轻人,比起老年人,对患者年龄本身的重视程度更低。

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