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Lau AMY, Wong ELY. Attitude towards Euthanasia among Medical Students: A Cross-Sectional Study in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137697. [PMID: 35805362 PMCID: PMC9265432 DOI: 10.3390/ijerph19137697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/17/2022] [Accepted: 06/18/2022] [Indexed: 02/01/2023]
Abstract
Background: With an increasing aging population and heavy medical burden, euthanasia has become a controversial topic in Hong Kong (HK) in recent years. Medical students are future medical professionals who may face novel and evolving ethical dilemmas. Hence, their views on euthanasia are crucial. Objective: To examine the attitudes of medical students towards euthanasia in HK and identify the factors associated with their attitude towards euthanasia. Methods: A questionnaire-based cross-sectional study among medical students in HK was conducted. The online anonymous questionnaires were distributed to all six years of students studying medicine at the Chinese University of Hong Kong (CUHK) and the University of Hong Kong (HKU), who provide medical training in HK. Attitude towards Euthanasia (ATE), measured using a five-point Likert Scale, was used to assess medical students’ attitudes towards euthanasia. Results: overall, 228 valid responses were received in 2021. The mean score of ATE was 29 (SD10.9), in which 134 (58.8%) of respondents showed a negative attitude towards euthanasia. Negative association was found between Christian (p-value = 0.003) and Catholic (p-value = 0.032) and the ATE score. Meanwhile, positive association was found between male gender (p-value = 0.011) and witnessed withdrawing of nutritional support from patient(s) (p-value = 0.011) and the ATE score. Conclusions: It is necessary for the government and schools to place more emphasis on euthanasia in the school curriculum by integrating ethical discussions and clinical attachment.
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Affiliation(s)
- Amy Mei-Yin Lau
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China;
| | - Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Correspondence: ; Tel.: +852-2252-8772; Fax: +852-2606-3500
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Saadeh R, Banat A, AbuZeina D, Al-Bourini T, Abdelqader E, Alrabadi N, Alfaqih MA, Allouh MZ. Factors Associated With University Students' Attitude Toward Euthanasia. OMEGA-JOURNAL OF DEATH AND DYING 2021; 87:20-37. [PMID: 34011208 DOI: 10.1177/00302228211016219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although euthanasia has been practiced for thousands of years, a wide controversy still exists around it. This study aimed to assess the attitude of university students toward euthanasia and its associated factors. The study included an online self-administered survey. Survey questions consisted of demographic information, psychological condition, and attitude toward euthanasia. A total of 1,188 students participated in the study. Approximately only one-third of the respondents (34.1%) viewed euthanasia as a moral practice, and just one-quarter (25.3%) supported legalizing it. The main reason for not supporting euthanasia was religious considerations (72.2%), followed by moral considerations (46.5%). Factors that predicted a positive attitude toward euthanasia (p < .05) included undefined religion, being male, feeling lonely, or having suicidal thoughts. Conclusively, the negative attitude toward euthanasia is primarily driven by religious beliefs. Furthermore, gender and psychological status play critical roles in students' attitudes toward euthanasia.
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Affiliation(s)
- Rami Saadeh
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Amani Banat
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Dalia AbuZeina
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Tasneem Al-Bourini
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Eman Abdelqader
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mahmoud A Alfaqih
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammed Z Allouh
- Department of Anatomy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.,Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
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Akbayram HT. Medical Faculty Students' Views on Euthanasia: Does It Change With Medical Education? ALPHA PSYCHIATRY 2021; 22:113-117. [PMID: 36425933 PMCID: PMC9590629 DOI: 10.5455/apd.126615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 10/20/2020] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Euthanasia is the decision to terminate the lives of patients who do not improve with medical treatment at their explicit request. This study was carried out to determine the opinions of medical students regarding euthanasia and to evaluate the effect of medical education on this issue. METHODS This cross-sectional study was conducted among first and sixth-year students of the Gaziantep University School of Medicine during the 2018-2019 academic years. RESULTS Of the 242 students who participated in the study, 54.1% (131) were first-year and 45.9% (111) were sixth-year students. Overall, 39.7% of the first-year students and 31.5% of the sixth-year students supported active euthanasia. The percentage of students who were against passive euthanasia and physician-assisted suicide (PAS) was 63.4% and 53.4% for first-year students and 49.5% and 54.1% for sixth-year students, respectively. CONCLUSION Approximately half of the first and the sixth-year students were opposed to active euthanasia, passive euthanasia, and PAS, and there was no significant difference between these two groups of students in their being against euthanasia. However, there were significant differences between these two groups with respect to their reasons against euthanasia.
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Affiliation(s)
- Hatice Tuba Akbayram
- Department of Family Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey
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Kauppinen H, Ahonen R, Mäntyselkä P, Timonen J. Medication safety and the usability of electronic prescribing as perceived by physicians-A semistructured interview among primary health care physicians in Finland. J Eval Clin Pract 2017; 23:1187-1194. [PMID: 28474487 DOI: 10.1111/jep.12759] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/24/2017] [Accepted: 03/24/2017] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES In Finland, a fully operational and nationwide electronic prescription (ePrescription) system was implemented by law in 2012 to 2015. From 2017, all prescriptions have to be electronic. ePrescriptions are intended to facilitate prescribing and to improve medication safety in Finnish health care. In this study, the aim was to explore physicians' experiences with the impacts of ePrescriptions on prescribing and medication safety in Finland. METHOD Data were collected by conducting 42 interviews among primary health care physicians in spring 2015. The data obtained were analyzed by means of qualitative content analysis. RESULTS Most of the physicians considered ePrescriptions to be convenient to issue because of the paperless procedure. Additionally, physicians stated that information concerning patients' prescriptions was better available through the Prescription Centre since physicians were able to check patients' prescriptions, including those issued elsewhere. In particular, ePrescriptions have improved the control of narcotics and medicines classified as primarily affecting the central nervous system. However, establishing a patient's overall medication through the Prescription Centre was regarded as difficult because prescription information was sometimes incoherent and had not been updated. The ePrescribing system was also described as inflexible, especially the correcting, cancelling, or renewing of ePrescriptions. For example, the system required too many "mouse clicks" and PIN entries to justify the actions taken in prescriptions. The system's slowness and the poor connection between physicians' electronic patient records and the Prescription Centre were also underlined. CONCLUSIONS According to the Finnish physicians interviewed, ePrescriptions have facilitated prescribing in some respects. However, the ePrescribing system still has problems and the Prescription Centre cannot be fully used for the management of a patient's overall medication.
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Affiliation(s)
- Hanna Kauppinen
- School of Pharmacy/Social Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Riitta Ahonen
- School of Pharmacy/Social Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Pekka Mäntyselkä
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Primary Health Care Unit, Hospital District of Northern Savo, Kuopio University Hospital, Kuopio, Finland
| | - Johanna Timonen
- School of Pharmacy/Social Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Enke M, Meyer P, Flor H. From Memory to Attitude: The Neurocognitive Process beyond Euthanasia Acceptance. PLoS One 2016; 11:e0153910. [PMID: 27088244 PMCID: PMC4835050 DOI: 10.1371/journal.pone.0153910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 04/06/2016] [Indexed: 11/30/2022] Open
Abstract
Numerous questionnaire studies on attitudes towards euthanasia produced conflicting results, precluding any general conclusion. This might be due to the fact that human behavior can be influenced by automatically triggered attitudes, which represent ingrained associations in memory and cannot be assessed by standard questionnaires, but require indirect measures such as reaction times (RT) or electroencephalographic recording (EEG). Event related potentials (ERPs) of the EEG and RT during an affective priming task were assessed to investigate the impact of automatically triggered attitudes and were compared to results of an explicit questionnaire. Explicit attitudes were ambivalent. Reaction time data showed neither positive nor negative associations towards euthanasia. ERP analyses revealed an N400 priming effect with lower mean amplitudes when euthanasia was associated with negative words. The euthanasia-related modulation of the N400 component shows an integration of the euthanasia object in negatively valenced associative neural networks. The integration of all measures suggests a bottom-up process of attitude activation, where automatically triggered negative euthanasia-relevant associations can become more ambiguous with increasing time in order to regulate the bias arising from automatic processes. These data suggest that implicit measures may make an important contribution to the understanding of euthanasia-related attitudes.
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Affiliation(s)
- Martin Enke
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Patric Meyer
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Jylhänkangas L, Smets T, Cohen J, Utriainen T, Deliens L. Descriptions of euthanasia as social representations: comparing the views of Finnish physicians and religious professionals. SOCIOLOGY OF HEALTH & ILLNESS 2014; 36:354-368. [PMID: 24033568 DOI: 10.1111/1467-9566.12057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In many western societies health professionals play a powerful role in people's experiences of dying. Religious professionals, such as pastors, are also confronted with the issues surrounding death and dying in their work. It is therefore reasonable to assume that the ways in which death-related topics, such as euthanasia, are constructed in a given culture are affected by the views of these professionals. This qualitative study addresses the ways in which Finnish physicians and religious professionals perceive and describe euthanasia and conceptualises these descriptions and views as social representations. Almost all the physicians interviewed saw that euthanasia does not fit the role of a physician and anchored it to different kinds of risks such as the slippery slope. Most of the religious and world-view professionals also rejected euthanasia. In this group, euthanasia was rejected on the basis of a religious moral code that forbids killing. Only one of the religious professionals - the freethinker with an atheist world-view - accepted euthanasia and described it as a personal choice, as did the one physician interviewed who accepted it. The article shows how the social representations of euthanasia are used to protect professional identities and to justify their expert knowledge of death and dying.
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Leppert W, Gottwald L, Majkowicz M, Kazmierczak-Lukaszewicz S, Forycka M, Cialkowska-Rysz A, Kotlinska-Lemieszek A. A comparison of attitudes toward euthanasia among medical students at two Polish universities. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:384-391. [PMID: 23055130 PMCID: PMC3664753 DOI: 10.1007/s13187-012-0414-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The aim of the study conducted upon completion of obligatory palliative medicine courses among 588 medical students at two universities was to compare their attitudes toward euthanasia. Four hundred ninety-two (84.97 %) students were Catholics; 69 (11.73 %) declared they would practice euthanasia, 303 (51.53 %) would not, and 216 students (36.73 %) were not sure. The idea of euthanasia legalisation was supported by 174 (29.59 %) respondents, opposed by 277 (47.11 %), and 137 (23.30 %) were undecided. Five hundred fifty-six (94.56 %) students did not change their attitudes toward euthanasia after palliative medicine courses. Students from the two universities were found to have different opinions on practicing euthanasia, euthanasia law and possible abuse which might follow euthanasia legalisation, but they shared similar views on the choice of euthanasia if they themselves were incurably ill and the legalisation of euthanasia. Gender and religion influenced students' answers. Differences observed between medical students at the two universities might be related to gender and cultural differences.
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Affiliation(s)
- Wojciech Leppert
- Chair and Department of Palliative Medicine, Poznan University of Medical Sciences, Osiedle Rusa 25 A, 61-245, Poznan, Poland.
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Kouwenhoven PSC, Raijmakers NJH, van Delden JJM, Rietjens JAC, Schermer MHN, van Thiel GJMW, Trappenburg MJ, van de Vathorst S, van der Vegt BJ, Vezzoni C, Weyers H, van Tol DG, van der Heide A. Opinions of health care professionals and the public after eight years of euthanasia legislation in the Netherlands: a mixed methods approach. Palliat Med 2013; 27:273-80. [PMID: 22695742 DOI: 10.1177/0269216312448507] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The practice of euthanasia and physician-assisted suicide (PAS) in the Netherlands has been regulated since 2002 by the Euthanasia Act. In the ongoing debate about the interpretation of this Act, comparative information about the opinions of the different stakeholders is needed. AIM To evaluate the opinions of Dutch physicians, nurses and the general public on the legal requirements for euthanasia and PAS. DESIGN A cross-sectional survey among Dutch physicians and nurses in primary and secondary care and members of the Dutch general public, followed by qualitative interviews among selected respondents. The participants were: 793 physicians, 1243 nurses and 1960 members of the general public who completed the questionnaire; 83 were interviewed. RESULTS Most respondents agreed with the requirement of a patient request (64-88%) and the absence of a requirement concerning life expectancy (48-71%). PAS was thought acceptable by 24-39% of respondents for patients requesting it because of mental suffering due to loss of control, chronic depression or early dementia. In the case of severe dementia, one third of physicians, 58% of nurses and 77% of the general public agreed with performing euthanasia based on an advance directive. Interviewees illustrated these findings and supported the Act. CONCLUSIONS Health care professionals and the general public mostly support the legal requirements for euthanasia and PAS. The law permits euthanasia or PAS for mental suffering but this possibility is not widely endorsed. The general public is more liberal towards euthanasia for advanced dementia than health care professionals. We conclude that there is ample support for the law after eight years of legal euthanasia.
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Gamliel E. To end life or not to prolong life: The effect of message framing on attitudes toward euthanasia. J Health Psychol 2012; 18:693-703. [DOI: 10.1177/1359105312455078] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
People ascribe “euthanasia” different values and view it differently. This study hypothesized that a different framing of objectively the same euthanasia situations would affect people’s attitudes toward it. Indeed, “positive” framing of euthanasia as not prolonging life resulted in more support for both passive and active euthanasia relative to “negative” framing of the objectively same situations as ending life. Two experiments replicated this pattern using either continuous measures of attitude or dichotomous measures of choice. The article offers two theoretical explanations for the effect of message framing on attitudes toward euthanasia, discusses implications of this effect, and suggests future research.
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Silvoniemi M, Vasankari T, Vahlberg T, Vuorinen E, Clemens KE, Salminen E. Physicians’ self-assessment of cancer pain treatment skills—more training required. Support Care Cancer 2012; 20:2747-53. [DOI: 10.1007/s00520-012-1396-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 01/25/2012] [Indexed: 10/14/2022]
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