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瑞典姑息治疗专业人员对医疗协助死亡的态度。

Attitudes Toward Medical Assistance in Dying Among Swedish Palliative Care Professionals.

作者信息

Segerlantz Mikael, Beck Ingela, Björk Joar, Elmlund Mattias, Fürst Carl Johan, Jacobsen Juliet, Rasmussen Birgit, Schelin Maria E C

机构信息

Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Institute for Palliative Care, Faculty of Medicine, Lund University, Sweden.

Institute for Palliative Care, Primary Health Care Skåne, Region Skåne, Lund, Sweden.

出版信息

J Palliat Med. 2025 Feb;28(2):175-184. doi: 10.1089/jpm.2024.0183. Epub 2024 Dec 13.

Abstract

The debate over legalizing medical assistance in dying (assisted dying) is ongoing, also in Nordic countries such as Sweden where assisted dying is illegal. A 2020 survey by the Swedish Medical Association highlighted varied perspectives, with 41% of physicians supporting and 34% opposing legalization. Professionals in palliative care were more negative toward it. To assess attitudes toward the legalization of, and the need for education about, assisted dying among Swedish palliative care professionals. A survey with 19 closed- and 2 open-ended questions was administered to the participants of the 2023 Swedish National Conference on Palliative Care (including physicians, nurses, assistant nurses, administrators, and researchers). Of the 866 conference participants who were invited, 444 (51%) participated. Predominantly, the cohort comprised women (89%); 60% were nurses and 17% physicians. The results showed that 38% opposed euthanasia, 36% supported it, and 26% remained undecided, with similar findings regarding physician-assisted suicide. There was a significant trend of increasingly negative attitudes with age and experience in palliative care ( < 0.01). Physicians emerged as the group most opposed to euthanasia (80%), whereas assistant nurses were the most positive, with 13% opposing legalization, and 33% of the nurses opposed euthanasia. The open-ended questions revealed thoughts regarding the complexity of the issue and the need for further discussion and education. In Sweden, where euthanasia and physician-assisted suicide is illegal, more than one-third of palliative care professionals were in favor of legalizing these practices while one-fourth were undecided, these proportions differed markedly between professions. Further, we uncovered a significant need for further discussion and education.

摘要

关于医疗协助死亡(安乐死)合法化的辩论仍在继续,在瑞典等北欧国家也是如此,在瑞典安乐死是非法的。瑞典医学协会2020年的一项调查突出了不同的观点,41%的医生支持合法化,34%的医生反对。姑息治疗专业人员对此的态度更为消极。为了评估瑞典姑息治疗专业人员对安乐死合法化的态度以及对相关教育的需求。对2023年瑞典全国姑息治疗会议的参与者(包括医生、护士、助理护士、管理人员和研究人员)进行了一项包含19个封闭式问题和2个开放式问题的调查。在866名受邀参会者中,444人(51%)参与了调查。该群体主要为女性(89%);60%是护士,17%是医生。结果显示,38%的人反对安乐死,36%的人支持,26%的人未作决定,对于医生协助自杀也有类似的结果。随着年龄增长和姑息治疗经验增加,态度呈明显越来越消极的趋势(<0.01)。医生是最反对安乐死的群体(80%),而助理护士态度最为积极,13%的助理护士反对合法化,33%的护士反对安乐死。开放式问题揭示了关于该问题复杂性以及进一步讨论和教育必要性的想法。在瑞典,安乐死和医生协助自杀是非法的,超过三分之一的姑息治疗专业人员支持这些做法合法化,而四分之一的人未作决定,这些比例在不同职业之间有显著差异。此外,我们发现非常有必要进行进一步的讨论和教育。

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