Lee M A, Nelson H D, Tilden V P, Ganzini L, Schmidt T A, Tolle S W
Department of Medicine, Oregon Health Sciences University, Portland 97201, USA.
N Engl J Med. 1996 Feb 1;334(5):310-5. doi: 10.1056/NEJM199602013340507.
Since the Oregon Death with Dignity Act was passed in November 1994, physicians in Oregon have faced the prospect of legalized physician-assisted suicide. We studied the attitudes and current practices of Oregon physicians in relation to assisted suicide.
From March to June 1995, we conducted a cross-sectional mailed survey of all physicians who might be eligible to prescribe a lethal dose of medication if the Oregon law is upheld. Physicians were asked to complete and return a confidential 56-item questionnaire.
Of the 3944 eligible physicians who received the questionnaire, 2761 (70 percent) responded. Sixty percent of the respondents thought physician-assisted suicide should be legal in some cases, and nearly half (46 percent) might be willing to prescribe a lethal dose of medication if it were legal to do so; 31 percent of the respondents would be unwilling to do so on moral grounds. Twenty-one percent of the respondents have previously received requests for assisted suicide, and 7 percent have complied. Half the respondents were not sure what to prescribe for this purpose, and 83 percent cited financial pressure as a possible reason for such requests. The respondents also expressed concern about complications of suicide attempts and doubts about their ability to predict survival at six months accurately.
Oregon physicians have a more favorable attitude toward legalized physician-assisted suicide, are more willing to participate, and are currently participating in greater numbers than other surveyed groups of physicians in the United States. A sizable minority of physicians in Oregon objects to legalization and participation on moral grounds. Regardless of their attitudes, physicians had a number of reservations about the practical applications of the act.
自1994年11月俄勒冈州《尊严死亡法案》通过以来,俄勒冈州的医生面临着医生协助自杀合法化的前景。我们研究了俄勒冈州医生对协助自杀的态度和当前做法。
1995年3月至6月,我们对所有如果俄勒冈州法律得到支持就可能有资格开具致命剂量药物的医生进行了横断面邮寄调查。要求医生填写并返还一份包含56个条目的保密问卷。
在收到问卷的3944名符合条件的医生中,2761名(70%)做出了回应。60%的受访者认为在某些情况下医生协助自杀应该合法化,近一半(46%)的受访者表示如果这样做合法,他们可能愿意开具致命剂量的药物;31%的受访者出于道德原因不愿意这样做。21%的受访者此前收到过协助自杀的请求,7%的受访者已予以同意。一半的受访者不确定为此应开具什么药物,83%的受访者认为经济压力可能是提出此类请求的一个原因。受访者还对自杀未遂的并发症表示担忧,并对他们准确预测患者六个月生存率的能力表示怀疑。
与美国其他接受调查群体的医生相比,俄勒冈州的医生对医生协助自杀合法化的态度更为支持,更愿意参与,且目前参与的人数更多。俄勒冈州有相当一部分少数医生出于道德原因反对合法化和参与。无论他们的态度如何,医生们对该法案的实际应用都有一些保留意见。