Bachman J G, Alcser K H, Doukas D J, Lichtenstein R L, Corning A D, Brody H
Survey Research Center, University of Michigan, Ann Arbor 48106-1248, USA.
N Engl J Med. 1996 Feb 1;334(5):303-9. doi: 10.1056/NEJM199602013340506.
There has been a continuing public debate about assisted suicide and the proper role, if any, of physicians in this practice. Legislative bans and various forms of legalization have been proposed.
We mailed questionnaires to three stratified random samples of Michigan physicians in specialties likely to involve the care of terminally ill patients: 500 in the spring of 1994, 500 in the summer of 1994, and 600 in the spring of 1995. Similar questionnaires were mailed to stratified random samples of Michigan adults: 449 in the spring of 1994 and 899 in the summer of 1994. Several different questionnaire forms were used, all of which included questions about whether physician-assisted suicide should be banned in Michigan or legalized under certain conditions.
Usable questionnaires were returned by 1119 of 1518 physicians eligible for the study (74 percent), and 998 of 1307 eligible adults in the sample of the general public (76 percent). Asked to choose between legalization of physician-assisted suicide and an explicit ban, 56 percent of physicians and 66 percent of the public support legalization, 37 percent of physicians and 26 percent of the public preferred a ban, and 8 percent of each group were uncertain. When the physicians were given a wider range of choices, 40 percent preferred legalization, 37 percent preferred "no law" (i.e., no government regulation), 17 percent favored prohibition, and 5 percent were uncertain. If physician-assisted suicide were legal, 35 percent of physicians said they might participate if requested--22 percent would participate in either assisted suicide or voluntary euthanasia, and 13 percent would participate only in assisted suicide. Support for physician-assisted suicide was lowest among the strongly religious.
Most Michigan physicians prefer either the legalization of physician-assisted suicide or no law at all; fewer than one fifth prefer a complete ban on the practice. Given a choice between legalization and a ban, two thirds of the Michigan public prefer legalization and one quarter prefer a ban.
关于协助自杀以及医生在这种行为中应扮演的恰当角色(如果有),公众一直在进行持续的辩论。已经有人提出立法禁令和各种形式的合法化建议。
我们向密歇根州三类可能涉及绝症患者护理的专科医生分层随机样本邮寄了调查问卷:1994年春季500名,1994年夏季500名,1995年春季600名。类似的调查问卷被邮寄给密歇根州成年人分层随机样本:1994年春季449名,1994年夏季899名。使用了几种不同的问卷形式,所有问卷都包含关于密歇根州是否应禁止医生协助自杀或在某些条件下使其合法化的问题。
符合研究条件的1518名医生中有1119名(74%)返回了可用问卷,普通公众样本中1307名符合条件的成年人中有998名(76%)返回了可用问卷。在被要求在医生协助自杀合法化和明确禁令之间做出选择时,56%的医生和66%的公众支持合法化,37%的医生和26%的公众倾向于禁令,每组各有8%的人不确定。当医生有更广泛的选择范围时,40%的人倾向于合法化,37%的人倾向于“无法律规定”(即无政府监管),17%的人支持禁止,5%的人不确定。如果医生协助自杀合法化,35%的医生表示如果被请求他们可能会参与——22%的人会参与协助自杀或自愿安乐死,13%的人只会参与协助自杀。在虔诚的宗教信徒中,对医生协助自杀的支持率最低。
大多数密歇根州的医生要么倾向于医生协助自杀合法化,要么倾向于完全无法律规定;不到五分之一的医生倾向于完全禁止这种做法。在合法化和禁令之间做出选择时,三分之二的密歇根州公众倾向于合法化,四分之一的人倾向于禁令。