Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico D.F., Mexico.
Arch Med Res. 2013 Aug;44(6):475-8. doi: 10.1016/j.arcmed.2013.07.005. Epub 2013 Aug 22.
To explore opinions of young residents and medical students on physician-assisted death (PAD).
A questionnaire was answered by 140 residents at the beginning of their residency and 99 third- or fourth-year medical students (46 attended religiously administered medical schools [RAMS] and 53 lay-administered medical schools [LAMS]). Main questions were agreement with PAD, therapy withdrawal (TW) and personalized PAD (PPAD) on whether participants themselves would seek help to die.
There were no differences of acceptance between residents and students but LAMS students had significantly higher agreement than RAMS students for PAD (68 vs. 33%), TW (79 vs. 39%) and PPAD (57 vs. 48%). LAMS students were also more willing to agree to a physician prescribe/inject a lethal drug, even if PAD were not legalized. However, legality was also an important issue, i.e., 25-58% of those unsure or opposed to PAD would reverse the decision if PAD were legalized, and 42-54% of those unwilling to TW would also reverse if written consent of the patient existed. Overall acceptance of residents and students was significantly higher than our previous study in nearly 1,000 older physicians (50 vs. 39% for PAD and 58 vs. 48% for TW).
PAD and TW acceptability seems to be increasing in Mexico, probably as a result of evolving social attitudes that appeared to be counteracted by a more conservative upbringing at home in our young RAMS students.
探索年轻住院医师和医学生对医师协助死亡(PAD)的看法。
140 名住院医师和 99 名三、四年级医学生(46 名就读于宗教管理医学院[RAMS],53 名就读于非宗教管理医学院[LAMS])在开始住院医师生涯时回答了一份问卷。主要问题是参与者本人是否会寻求帮助以结束生命,对 PAD、治疗退出(TW)和个性化 PAD(PPAD)的意见。
住院医师和学生之间的接受程度没有差异,但 LAMS 学生对 PAD(68%比 33%)、TW(79%比 39%)和 PPAD(57%比 48%)的同意率明显高于 RAMS 学生。LAMS 学生也更愿意同意医生开/注射致命药物,即使 PAD 尚未合法化。然而,合法性也是一个重要问题,即 25%-58%的不确定或反对 PAD 的人如果 PAD 合法化,会改变决定,而 42%-54%的不愿意 TW 的人如果存在患者书面同意,也会改变决定。住院医师和学生的总体接受度明显高于我们之前对近 1000 名老年医生的研究(PAD 为 50%比 39%,TW 为 58%比 48%)。
PAD 和 TW 的可接受性似乎在墨西哥有所增加,这可能是由于社会态度的演变,而这种演变似乎被我们年轻的 RAMS 学生在家庭中更保守的教养所抵消。