Pousset G, Bilsen J, De Wilde J, Deliens L, Mortier F
Bioethics Institute Ghent, Ghent University, Ghent, Belgium.
Child Care Health Dev. 2009 May;35(3):349-56. doi: 10.1111/j.1365-2214.2008.00933.x. Epub 2009 Jan 14.
The aim of the study was to investigate attitudes of secondary school students towards acceptability of requests by minors for end-of-life decisions (ELDs) with a possible life-shortening effect: non-treatment decisions, potentially life-shortening alleviation of pain and symptoms (APS) and euthanasia.
A cross-sectional survey was conducted among second and fourth grades students in 20 secondary schools in Flanders, Belgium. An anonymous structured questionnaire was administered to measure attitudes towards acceptability of requests for euthanasia and other ELDs, towards the right to be informed about terminal prognosis and their own desire to be informed.
In total, 1769 students participated. In case of a terminal patient, 61% found a request for euthanasia acceptable, 60% a request for APS and 69% a request for non-treatment decision, compared with 18% (euthanasia) and 50% (APS) in case of a non-terminal patient. Acceptance was highest among: boys, participants older than 14 years and participants from general as opposed to technical and vocational education. Sixty-six per cent said the parents' opinion not being asked was a circumstance that should hold back a physician from administering a lethal drug. Ninety per cent of participants thought a minor has the right to be informed about terminal prognosis of a disease while 78% would like to be informed themselves.
Attitudes towards ELD requests varied with case and participant characteristics and type of ELD. The studied adolescents have a clear wish to be informed about terminal prognosis. Physicians and caregivers should adequately involve adolescents in decision making and tailor prognosis-related information to their needs and level of competency.
本研究旨在调查中学生对于未成年人提出的可能缩短生命的临终决定（ELD）请求的接受态度，这些请求包括：不进行治疗的决定、可能缩短生命的减轻疼痛和症状（APS）以及安乐死。
在比利时弗拉芒地区的20所中学对二年级和四年级学生进行了横断面调查。采用匿名结构化问卷来测量对安乐死和其他临终决定请求的接受态度、了解终末期预后的权利以及他们自己希望得到相关信息的意愿。
共有1769名学生参与。对于终末期患者，61%的人认为安乐死请求是可以接受的，60%的人认为减轻疼痛和症状的请求是可以接受的，69%的人认为不进行治疗的决定是可以接受的；而对于非终末期患者，相应的比例分别为18%（安乐死）和50%（减轻疼痛和症状）。在以下人群中接受度最高：男生、14岁以上的参与者以及接受普通教育而非技术和职业教育的参与者。66%的人表示，不征求父母意见这一情况应使医生不给予致命药物。90%的参与者认为未成年人有权了解疾病的终末期预后，而78%的人希望自己得到相关信息。
对临终决定请求的态度因情况、参与者特征和临终决定类型而异。所研究的青少年明确希望了解终末期预后。医生和护理人员应让青少年充分参与决策，并根据他们的需求和能力水平提供与预后相关的信息。
