Hall M, Trachtenberg F, Dugan E
Wake Forest University, School of Medicine, Department of Public Health Sciences, Winston-Salem, NC 27157-1063, USA.
J Med Ethics. 2005 Dec;31(12):693-7. doi: 10.1136/jme.2004.011452.
Little empirical evidence exists to support either side of the ongoing debate over whether legalising physician aid in dying would undermine patient trust.
A random national sample of 1117 US adults were asked about their level of agreement with a statement that they would trust their doctor less if "euthanasia were legal [and] doctors were allowed to help patients die".
There was disagreement by 58% of the participants, and agreement by only 20% that legalising euthanasia would cause them to trust their personal physician less. The remainder were neutral. These attitudes were the same in men and women, but older people and black people had more agreement that euthanasia would lower trust. However, overall, only 27% of elderly people (age 65+) and 32% of black people thought that physician aid in dying would lower trust. These views differed with physical and mental health, and also with education and income, with those having more of these attributes tending to view physician aid in dying somewhat more favourably. Again, however, overall views in most of these subgroups were positive. Views about the effect of physician aid in dying on trust were significantly correlated with participants' underlying trust in their physicians and their satisfaction with care. In a multivariate regression model, trust, satisfaction, age, and white/black race remained independently significant.
Despite the widespread concern that legalising physician aid in dying would seriously threaten or undermine trust in physicians, the weight of the evidence in the USA is to the contrary, although views vary significantly.
关于医生协助死亡合法化是否会破坏患者信任的这场持续辩论,双方都缺乏实证证据支持。
对1117名美国成年人进行全国随机抽样,询问他们对“如果安乐死合法化且医生被允许帮助患者死亡,他们会对医生的信任度降低”这一说法的认同程度。
58%的参与者表示不同意,只有20%的人认为安乐死合法化会使他们对私人医生的信任度降低。其余人持中立态度。男性和女性的态度相同,但老年人和黑人更认同安乐死会降低信任度。然而,总体而言,只有27%的老年人(65岁及以上)和32%的黑人认为医生协助死亡会降低信任度。这些观点因身心健康状况、教育程度和收入水平而异,具备这些特征越多的人对医生协助死亡的看法往往越积极。不过,大多数这些亚组的总体看法仍然是积极的。关于医生协助死亡对信任的影响的观点与参与者对医生的潜在信任以及他们对医疗护理的满意度显著相关。在多元回归模型中,信任度、满意度、年龄以及白人/黑人种族仍然具有独立的显著性。
尽管人们普遍担心医生协助死亡合法化会严重威胁或破坏对医生的信任,但美国的证据权重却与之相反,尽管观点差异很大。