Section of Legal Medicine, Department of Internal Medicine and Public Medicine, University of Bari, Bari, Italy.
Intensive Care Med. 2011 Mar;37(3):542-9. doi: 10.1007/s00134-011-2132-5. Epub 2011 Feb 2.
Ethical issues regarding patient care have recently been raised in Italy by the case of Eluana Englaro, a 36-year-old woman who remained in a persistent vegetative state (PVS) for 17 years. There are no specific laws on the books in Italy regarding euthanasia and physician-assisted suicide. In November 2008, a controversial decision by the Italian Supreme Court granted the woman's father his wish to discontinue nutrition and hydration provided to her. Because of this historic decision, the authors carried out a survey of Italian physicians' beliefs regarding end-of-life practices.
A questionnaire was e-mailed to 70,000 physicians working for the Italian Public Health System and University Medical Hospitals.
A total of 22,219 doctors responded to the questionnaire (32.3%), of whom 17,252 (77.6%) had some experience in treating PVS patients. Nearly 70% of responding doctors were aware of PVS diagnostic criteria; most of them (61%) considered tube feeding to be a medical therapy, and 66% of respondents believed that withdrawal of assisted nutrition and hydration (ANH) might be appropriate depending on the patient's wishes. Moreover, even though 50% of doctors surveyed were not in favor of euthanasia, a significant percentage (42%) did approve of it, while 8% of this sample was uncertain.
Italian doctors probably have the least experience in end-of-life decisions in Europe, therefore this national survey is a great chance to understand their authentic opinions regarding such remarkable issues. There is broad consensus that a clear legislative position regarding euthanasia and ANH is needed.
最近，意大利发生了埃卢安娜·恩格拉罗（Eluana Englaro）的案例，这位 36 岁的女性处于持续植物人状态（PVS）已经 17 年，由此引发了有关患者护理的伦理问题。意大利目前没有关于安乐死和医生协助自杀的具体法律。2008 年 11 月，意大利最高法院做出了一项有争议的决定，批准了这名女性的父亲停止向她提供营养和水合作用的愿望。由于这一历史性的决定，作者对意大利医生关于临终实践的信念进行了调查。
向为意大利公共卫生系统和大学医疗医院工作的 70000 名医生发送了一份电子邮件调查问卷。
共有 22219 名医生对问卷做出了回应（32.3%），其中 17252 名（77.6%）有治疗 PVS 患者的经验。近 70%的回应医生了解 PVS 的诊断标准；他们中的大多数（61%）认为管饲是一种医疗疗法，66%的受访者认为根据患者的意愿，停止辅助营养和水合作用（ANH）可能是合适的。此外，尽管 50%的被调查医生不赞成安乐死，但仍有相当比例（42%）的医生赞成安乐死，而该样本中有 8%的人对此表示不确定。
意大利医生可能在欧洲的临终决策方面经验最少，因此这项全国性调查是了解他们对这些重要问题真实看法的绝佳机会。人们普遍认为，需要对安乐死和 ANH 有明确的立法立场。
