Amzat Jimoh, Kanmodi Kehinde Kazeem, Ismail Abbas, Egbedina Eyinade Adeduntan
Department of Sociology Usmanu Danfodiyo University Sokoto Nigeria.
Department of Sociology University of Johannesburg Johannesburg South Africa.
Health Sci Rep. 2023 May 30;6(5):e1239. doi: 10.1002/hsr2.1239. eCollection 2023 May.
The core ethical perplexity is that physician-assisted suicide and euthanasia (PAS/E) contradicts the core value of medical practice which is about the duty of care to preserve life. While most arguments for and against euthanasia emerge from other continents, no African country legalizes or decriminalizes PAS/E. The essence of this scoping review is to collate evidence and scientific voices on euthanasia in Africa by synthesizing empirical articles on the subject in Africa.
In this scoping review, a systematic search of five electronic research databases-PubMed, SCOPUS, CINHAL Complete, Allied and Complementary Medicine (AMED), and APA PsycInfo-was conducted to identify relevant articles conducted in Africa on euthanasia. After deduplication with the Rayyan software, the retrieved literature were screened for eligibility, and only eligible articles were included in the review. Relevant data from these articles were extracted and analyzed using narrative synthesis.
Only 14 articles reporting empirical studies, conducted in Africa, and published in English, were included in the review after a rigorous screening process. The review shows a wide rejection of euthanasia, but there is not much resistance to passive euthanasia, that is, withholding/withdrawing life-saving medical care from a terminally ill patient, mostly due to advanced age of the patient and the incurability of the illness. Many factors, such as religion, profession, and age help in shaping the way an individual view and understand PAS/E. Professionals take the patient's clinical condition and sociocultural context into consideration when making decisions about end-of-life care. The sociocultural context did not favor PAS/E.
Euthanasia will continue to be a subject of controversy and debate in Africa and elsewhere. The majority of Africans hold the duty of care and preservation of life as the hallmark of medical practice, which informs the wide rejection of PAS/E.
核心伦理困境在于,医生协助自杀和安乐死(PAS/E)与医疗实践的核心价值相矛盾,而医疗实践的核心价值是关乎保护生命的照护职责。虽然支持和反对安乐死的大多数论据都来自其他大洲,但没有一个非洲国家将PAS/E合法化或非罪化。本范围综述的实质是通过综合非洲关于该主题的实证文章,整理非洲有关安乐死的证据和科学观点。
在本范围综述中,对五个电子研究数据库——PubMed、SCOPUS、CINHAL Complete、联合与补充医学数据库(AMED)以及美国心理学会心理学文摘数据库(APA PsycInfo)进行了系统检索,以识别在非洲进行的有关安乐死的相关文章。使用Rayyan软件去重后,对检索到的文献进行资格筛选,只有符合条件的文章才纳入综述。从这些文章中提取相关数据,并采用叙述性综合分析方法进行分析。
经过严格筛选过程后,综述仅纳入了14篇在非洲进行的、以英文发表的报道实证研究的文章。该综述表明,人们广泛反对安乐死,但对被动安乐死,即不给身患绝症的患者提供/停止提供挽救生命的医疗护理,并没有太多抵制,这主要是由于患者年事已高且疾病无法治愈。许多因素,如宗教、职业和年龄,有助于塑造个人看待和理解PAS/E的方式。专业人员在做出临终护理决策时会考虑患者的临床状况和社会文化背景。社会文化背景不支持PAS/E。
在非洲和其他地方,安乐死将继续是一个有争议和辩论的话题。大多数非洲人将照护职责和保护生命视为医疗实践的标志,这导致人们广泛反对PAS/E。