Doukas D J, Waterhouse D, Gorenflo D W, Seid J
Department of Family Practice, University of Michigan, Ann Arbor 48109, USA.
J Clin Oncol. 1995 May;13(5):1055-61. doi: 10.1200/JCO.1995.13.5.1055.
To ascertain the attitudes of oncologists toward physician-assisted death, ie, physician-assisted suicide and active euthanasia, as well as their experiences with these activities and their opinions toward their legalization.
A survey was mailed to all practicing 250 oncologists in the state of Michigan, with subsequent development of psychometric scales and their correlation with self-reported behaviors in physician-assisted death.
Analysis revealed five distinct, meaningful factors regarding approval or disapproval of physician-assisted death. These factors reflected global attitudes toward physician-assisted death, passive euthanasia, philosophical prohibitions toward physician-assisted death, concerns of legal consequences with physician-assisted death, and attitudes that physician-assisted death could be avoided with better end-of-life care (alpha = .94, .74, .76, .87, and .84, respectively). High levels of therapy withdrawal were reported (81%), with significant reservations toward assisted suicide and active euthanasia, although reported participation in such actions was noteworthy (18% and 4%, respectively). The scales reflecting global and philosophical attitudes correlated with several attitudes and behaviors toward physician-assisted death (P < .001). Legislation that would allow physician-assisted death was favored by 20.8% of respondents.
Although they have reservations about physician-assisted death, significant numbers of oncologists are willing to consider such actions should they become legal. Given the substantial number of physicians who report that they have already participated in physician-assisted death, these findings may help better understand the attitudes that motivate physician behaviors toward assisted death.
确定肿瘤学家对医生协助死亡(即医生协助自杀和主动安乐死)的态度,以及他们在这些行为方面的经历和对其合法化的看法。
向密歇根州所有执业的250名肿瘤学家邮寄了一份调查问卷,随后编制了心理测量量表,并将其与医生协助死亡方面的自我报告行为进行关联。
分析揭示了关于赞成或反对医生协助死亡的五个不同且有意义的因素。这些因素反映了对医生协助死亡的总体态度、被动安乐死、对医生协助死亡的哲学性禁令、对医生协助死亡法律后果的担忧,以及认为通过更好的临终关怀可以避免医生协助死亡的态度(α分别为0.94、0.74、0.76、0.87和0.84)。报告显示有较高比例的治疗撤减情况(81%),对协助自杀和主动安乐死存在重大保留意见,尽管值得注意的是有一定比例的人报告参与了此类行为(分别为18%和4%)。反映总体和哲学态度的量表与对医生协助死亡的几种态度和行为相关(P < 0.001)。20.8%的受访者赞成允许医生协助死亡的立法。
尽管肿瘤学家对医生协助死亡有所保留,但相当数量的人表示如果其合法化愿意考虑此类行为。鉴于有相当数量的医生报告他们已经参与了医生协助死亡,这些发现可能有助于更好地理解促使医生在协助死亡方面行为的态度。