Suarez-Almazor M E, Belzile M, Bruera E
Department of Public Health Sciences, Healthcare Quality and Outcomes Research Centre, University of Alberta, Edmonton, Canada.
J Clin Oncol. 1997 Feb;15(2):418-27. doi: 10.1200/JCO.1997.15.2.418.
There is an ongoing debate about the legalization of euthanasia. The attitudes and beliefs of the general public and physicians appear to differ; the views of patients have not been adequately explored. During 1995, we conducted a simultaneous survey in the province of Alberta, Canada, of a random sample of 1,240 individuals from the general population, 179 physicians, and 62 consecutive patients with terminal cancer. The same instrument was administered to the public and physicians through telephone interview, and to patients in a face-to-face interview. Statements related to the legalization of euthanasia and physician-assisted suicide were scored using 1-to-7 Likert agreement scales.
A slight majority of members of the public and terminally ill patients (50% to 60%) agreed with the legalization of euthanasia and assisted suicide, while most physicians (60% to 80%) opposed it. In multivariate analysis, independent associations with support of active end of life measures included the following: group surveyed, strength of religious beliefs, religion (highest support by individuals with no religion), education (lower education associated with higher support), and the perception of burden on families, and physical and emotional suffering by cancer patients.
In all groups, a marked polarization of attitudes was observed, with most individuals either strongly agreeing or strongly disagreeing with the statements in the survey. Although a slight majority of the public supported euthanasia, one third opposed it. Most physicians opposed these interventions and appeared not to be willing to perform these procedures if legalized. Our findings suggest that legalization at this time could be highly divisive and controversial from a societal perspective.
关于安乐死合法化的争论一直存在。公众和医生的态度与信念似乎有所不同；患者的观点尚未得到充分探讨。1995年期间，我们在加拿大艾伯塔省对1240名普通人群、179名医生以及62名晚期癌症患者进行了随机抽样同步调查。通过电话访谈向公众和医生发放相同的调查问卷，对患者则进行面对面访谈。使用1至7的李克特同意量表对与安乐死合法化及医生协助自杀相关的陈述进行评分。
略过半数的公众和绝症患者（50%至60%）赞同安乐死和协助自杀合法化，而大多数医生（60%至80%）表示反对。在多变量分析中，与支持积极生命终结措施相关的独立因素包括：调查群体、宗教信仰强度、宗教（无宗教信仰者支持率最高）、教育程度（教育程度较低者支持率较高）、对家庭负担的认知以及癌症患者的身体和情感痛苦。
在所有群体中，均观察到态度明显两极分化，大多数人要么强烈赞同要么强烈反对调查中的陈述。虽然略过半数的公众支持安乐死，但仍有三分之一的人反对。大多数医生反对这些干预措施，并且如果合法化似乎不愿意实施这些程序。我们的研究结果表明，从社会角度来看，此时合法化可能会引发高度分裂和争议。
