Schmidt T A, Zechnich A D, Tilden V P, Lee M A, Ganzini L, Nelson H D, Tolle S W
Oregon Health Sciences University, School of Medicine, Department of Emergency Medicine, Portland 97201-3098, USA.
Acad Emerg Med. 1996 Oct;3(10):938-45. doi: 10.1111/j.1553-2712.1996.tb03323.x.
To determine emergency physicians' (EPs') attitudes toward physician-assisted suicide (PAS), factors associated with those attitudes, current experiences with attempted suicides in terminally ill persons, and concerns about the impact of legalizing PAS on emergency medicine practice.
A cross-sectional, anonymous mailed survey was taken of EPs in the state of Oregon.
Of 356 eligible physicians, 248 (70%) returned the survey. Of the respondents, 69% indicated that PAS should be legal, 65% considered PAS consistent with the physician's role, and 19% believed that it is immoral. The respondents were concerned that patients might feel pressure if they perceived themselves to be either a care burden on others (82%) or a financial stress to others (69%). Only 37% indicated that the Oregon initiative has enough safeguards to protect vulnerable persons. Support for legalization was not associated with gender, age, or practice location. Respondents with no religious affiliation were most supportive of PAS (p < 0.001), and Catholic respondents were least suppportive (p = 0.03). A majority (58%) had treated at least 1 terminally ill patient after an apparent overdose. Most respondents (97%) indicated at least 1 circumstance for which they would sometimes be willing to let a terminally ill patient die without resuscitation after PAS if the Oregon initiative becomes law: if verified with an advance directive from the patient (81%), with documentation in writing from the physician (73%), after speaking to the primary physician (64%), if a competent patient verbally confirmed intent (60%), or if the family verbally confirmed intent (52%).
Although the majority of Oregon EPs favor the concept of legalization of PAS, most have concerns that safeguards in the Oregon initiative are inadequate to protect vulnerable patients. These physicians would consider not resuscitating terminally ill patients who have attempted suicide under the law's provisions, only in the setting of documentation of the patient's intent.
确定急诊医生对医生协助自杀（PAS）的态度、与这些态度相关的因素、目前对绝症患者自杀未遂情况的经历，以及对PAS合法化对急诊医疗实践影响的担忧。
对俄勒冈州的急诊医生进行了一项横断面、匿名邮寄调查。
在356名符合条件的医生中，248名（70%）回复了调查。在受访者中，69%表示PAS应该合法化，65%认为PAS与医生的角色相符，19%认为这是不道德的。受访者担心，如果患者认为自己是他人的护理负担（82%）或经济压力（69%），他们可能会感到压力。只有37%表示俄勒冈州的倡议有足够的保障措施来保护弱势群体。对合法化的支持与性别、年龄或执业地点无关。无宗教信仰的受访者最支持PAS（p<0.001），天主教受访者支持率最低（p = 0.03）。大多数（58%）曾治疗过至少1名明显过量服药后的绝症患者。大多数受访者（97%）表示，如果俄勒冈州的倡议成为法律，在至少1种情况下，如果PAS后他们有时会愿意让绝症患者不接受复苏而死亡：如果有患者的预先指示（81%）、医生的书面记录（73%）、与主治医生交谈后（64%）、如果有行为能力的患者口头确认意图（60%）或如果家属口头确认意图（52%）。
虽然俄勒冈州的大多数急诊医生赞成PAS合法化的概念，但大多数人担心俄勒冈州倡议中的保障措施不足以保护弱势群体。这些医生会考虑在法律规定的情况下，只有在有患者意图记录的情况下，才不对自杀未遂的绝症患者进行复苏。
