New Zealand Medical Students' Views of Euthanasia/assisted Dying Across Different Year Levels

Overview

Journal BMC Med Educ

Publisher Biomed Central

Specialty Medical Education

Date 2021 Feb 24

PMID 33622329

Citations 7

Authors

Luke Nie

Kelby Smith-Han

Ella Iosua

Simon Walker

Affiliations

Soon will be listed here.

Abstract

Background: Previous studies report a majority of the general public support euthanasia/assisted dying (EAD), while a majority of doctors are opposed. In considering policy decisions about EAD, some may discount the views of doctors because they take them to be based on personal values or tradition, rather than reasons that the general public might share. One way to explore this notion is to examine whether medical students' views change during their medical education. The objective of this study was to learn how New Zealand medical students view EAD and whether students at different year levels have different views.

Methods: An on-line survey of undergraduate medical students was conducted asking whether they supported a law change to allow EAD. Quantitative data was analysed using unadjusted and multiple logistic regression. Thematic analysis was conducted with the qualitative data.

Results: A total of 326 students replied to the survey. The overall response rate was 28%. 65% of 2nd year students were supportive of EAD, compared to 39% in 5th year. The odds of 5th year students supporting a law change compared to 2nd year was 0.30 (95% CI: 0.15-0.60). The predominant themes found in the qualitative results indicate that medical students support or oppose EAD for reasons similar to those found in the wider debate, and that their views are influenced by a range of factors. However, several at all year levels cited an aspect of medical school as having influenced their views. This was mentioned by participants who were supportive of, opposed to, or unsure about EAD, but it was the type of influence most often mentioned by those who were opposed.

Conclusions: The quantitative findings show students at the end of 5th year were less likely to support EAD than students at the end of 2nd year. We suggest that this difference is most likely due to their time in medical education. This suggests that the lower support found among doctors is in part related to medical education and medical work rather than age, personality, or social context. The qualitative findings indicate that this is not related to a particular educational experience at Otago Medical School but a range.

Citing Articles

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References

Emanuel E . Euthanasia. Historical, ethical, and empiric perspectives. Arch Intern Med. 1994; 154(17):1890-901. DOI: 10.1001/archinte.154.17.1890. View

Schildmann J, Herrmann E, Burchardi N, Schwantes U, Vollmann J . Physician assisted suicide: knowledge and views of fifth-year medical students in Germany. Death Stud. 2005; 30(1):29-39. DOI: 10.1080/07481180500236693. View

Oliver P, Wilson M, Malpas P . New Zealand doctors' and nurses' views on legalising assisted dying in New Zealand. N Z Med J. 2017; 130(1456):10-26. View

McCormack R, Clifford M, Conroy M . Attitudes of UK doctors towards euthanasia and physician-assisted suicide: a systematic literature review. Palliat Med. 2011; 26(1):23-33. DOI: 10.1177/0269216310397688. View

Stronegger W, Schmolzer C, Rasky E, Freidl W . Changing attitudes towards euthanasia among medical students in Austria. J Med Ethics. 2010; 37(4):227-9. DOI: 10.1136/jme.2010.039792. View

Peretti-Watel P, BenDiane M, Pegliasco H, Lapiana J, Favre R, Galinier A . Doctors' opinions on euthanasia, end of life care, and doctor-patient communication: telephone survey in France. BMJ. 2003; 327(7415):595-6. PMC: 194087. DOI: 10.1136/bmj.327.7415.595. View

Hafferty F . Beyond curriculum reform: confronting medicine's hidden curriculum. Acad Med. 1998; 73(4):403-7. DOI: 10.1097/00001888-199804000-00013. View

Gruber P, Gomersall C, Joynt G, Lee A, Tang P, Young A . Changes in medical students' attitudes towards end-of-life decisions across different years of medical training. J Gen Intern Med. 2008; 23(10):1608-14. PMC: 2533361. DOI: 10.1007/s11606-008-0713-y. View

Macleod R, Wilson D, Malpas P . Assisted or hastened death: the healthcare practitioner's dilemma. Glob J Health Sci. 2012; 4(6):87-98. PMC: 4776959. DOI: 10.5539/gjhs.v4n6p87. View

10.

Anneser J, Jox R, Thurn T, Borasio G . Physician-assisted suicide, euthanasia and palliative sedation: attitudes and knowledge of medical students. GMS J Med Educ. 2016; 33(1):Doc11. PMC: 4766939. DOI: 10.3205/zma001010. View

11.

Glebocka A, Gawor A, Ostrowski F . Attitudes toward euthanasia among Polish physicians, nurses and people who have no professional experience with the terminally ill. Adv Exp Med Biol. 2013; 788:407-12. DOI: 10.1007/978-94-007-6627-3_55. View

12.

Emanuel E, Onwuteaka-Philipsen B, Urwin J, Cohen J . Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the United States, Canada, and Europe. JAMA. 2016; 316(1):79-90. DOI: 10.1001/jama.2016.8499. View

13.

Voltmer E, Bussing A, Koenig H, Zaben F . Religiosity/spirituality of German doctors in private practice and likelihood of addressing R/S issues with patients. J Relig Health. 2013; 53(6):1741-52. DOI: 10.1007/s10943-013-9776-0. View

14.

Jacobs R, Hendricks M . Medical students' perspectives on euthanasia and physician-assisted suicide and their views on legalising these practices in South Africa. S Afr Med J. 2018; 108(6):484-489. DOI: 10.7196/SAMJ.2018.v108i6.13089. View

15.

Ramirez-Rivera J, Ramos O . Euthanasia and relief of suffering: attitudes of medical students. Bol Asoc Med P R. 1995; 87(10-12):164-6. View

16.

Clemens K, Klein E, Jaspers B, Klaschik E . Attitudes toward active euthanasia among medical students at two German universities. Support Care Cancer. 2008; 16(6):539-45. DOI: 10.1007/s00520-008-0427-z. View

17.

Marini M, Neuenschwander H, Stiefel F . Attitudes toward euthanasia and physician assisted suicide: a survey among medical students, oncology clinicians, and palliative care specialists. Palliat Support Care. 2006; 4(3):251-5. DOI: 10.1017/s1478951506060329. View

18.

Seale C . The role of doctors' religious faith and ethnicity in taking ethically controversial decisions during end-of-life care. J Med Ethics. 2010; 36(11):677-82. DOI: 10.1136/jme.2010.036194. View

19.

Sheahan L . Exploring the interface between 'physician-assisted death' and palliative care: cross-sectional data from Australasian palliative care specialists. Intern Med J. 2016; 46(4):443-51. DOI: 10.1111/imj.13009. View

20.

Bai M, Nicholson H, Smith-Han K . Medical students' experiences of practising medical procedures on patients, other students and themselves. N Z Med J. 2016; 129(1444):43-57. View