Balslev van Randwijk Christian, Opsahl Tobias, Assing Hvidt Elisabeth, Bjerrum Lars, Kørup Alex Kappel, Hvidt Niels Christian
Research Unit of General Practice, University of Southern Denmark, Odense, Denmark.
University College Capital, Copenhagen, Denmark.
J Relig Health. 2020 Oct;59(5):2654-2663. doi: 10.1007/s10943-020-01026-3.
Several studies in different countries have investigated the influence of physician characteristics (such as ethnicity, gender and personal values) on attitudes in end-of-life (EOL) decision-making. While patients and relatives formally decide about issues related to EOL, the physician often ends up with a pivotal role in the decision-making process. Consequently, the influence of the personal beliefs and values of physicians on decisions in EOL care is central in the clinical encounter. The aim of this study was to investigate whether the religious and spiritual characteristics of Danish physicians are associated with their attitudes toward certain EOL decisions, particularly concerning euthanasia (E), physician-assisted suicide (PAS), sedation into unconsciousness in dying patients (SUDP), and withdrawal of life support. The study is based on a questionnaire that was mailed to 1485 physicians in the Region of Southern Denmark. We found that being more religious meant being more likely to object to E/PAS, with gender also being a significant factor, in that females were more likely to object to E/PAS than males. Being more religious also meant being more likely to object to SUDP. In a medical practice, revolving around patient-centered care, and often linked with ideals of value neutrality, it is important to gain an understanding of the influences of personal values of physicians on attitudes toward several areas of clinical decision-making. This study contributes to the knowledge of, and possible reflections upon, the impact of physicians' personal beliefs and values on their attitudes toward important decisions in their patients' lives.
不同国家的多项研究调查了医生特征（如种族、性别和个人价值观）对临终（EOL）决策态度的影响。虽然患者和亲属正式决定与临终相关的问题，但医生往往在决策过程中起着关键作用。因此，医生的个人信仰和价值观对临终护理决策的影响在临床诊疗中至关重要。本研究的目的是调查丹麦医生的宗教和精神特征是否与他们对某些临终决策的态度相关，特别是关于安乐死（E）、医生协助自杀（PAS）、使临终患者镇静至昏迷（SUDP）以及撤除生命支持。该研究基于一份邮寄给丹麦南部地区1485名医生的问卷。我们发现，宗教信仰程度越高，越有可能反对安乐死/医生协助自杀，性别也是一个重要因素，女性比男性更有可能反对安乐死/医生协助自杀。宗教信仰程度越高，也越有可能反对使临终患者镇静至昏迷。在以患者为中心的医疗实践中，通常与价值中立的理想相关联，了解医生个人价值观对临床决策几个领域态度的影响很重要。本研究有助于了解医生个人信仰和价值观对其对患者生命中重要决策态度的影响，并可能引发相关思考。
