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PubMed2000

An exploratory pilot study of nurse-midwives' attitudes toward active euthanasia and abortion.

Over the past three decades, active euthanasia and abortion have received increasing international attention. Since both these practices are relevant to the role of the nurse-midwife, it is important to know what influences their attitudes towards them. Therefore, the purpose of this study was: 1, to survey the attitudes of nurse-midwives' to active euthanasia and its legalization; 2, to determine the relationship between nurse-midwives' attitudes toward active euthanasia and its legalization, and attitudes toward abortion, self-reported religiosity and religious affiliation. The study setting was an international midwifery conference and the sample consisted of 139 nurse-midwives attending the conference. The majority of nurse-midwives displayed a positive attitude toward active euthanasia and its legalization. In addition, there was a positive relationship between their attitude to abortion and active euthanasia. Self-reported religiosity and religious affiliation were significantly related to attitudes toward active euthanasia and its legalization. An interesting positive relationship between country of practice and attitudes to euthanasia was also found. Nurse-midwives practicing in countries with more liberal euthanasia and assisted suicide legislation were more supportive of active euthanasia. With the increasing acceptance of active euthanasia's legalization, the results of this study pose some ethical questions that nurse-midwives internationally will have to consider.

Abortion, Induced↗
PubMed1999

[Dying through the hand of man or taken by the hand of man? Results of an opinion poll concerning active euthanasia and the Hospice Movement].

BACKGROUND: Opinion polls show a growing support of active euthanasia in Germany. The hospice movement rejects active euthanasia and pleads for a qualified care for the dying. The aim of our study was to evaluate how far the work and the ideas of the hospice movement are known in Germany and to which extend this knowledge influences the attitude towards active euthanasia. METHODS: An interview of 200 people in the pedestrian area of Mainz was undertaken. RESULTS: 73% of all interviewees supported active euthanasia. Significant predictors for opposition to active euthanasia were increasing age and belonging to the roman catholic confession. However, 72% of active euthanasia supporters did not know what a hospice is, and 80% were not aware of the existence of such an establishment in Mainz. Opponents of euthanasia had significantly more knowledge of these items. CONCLUSION: The results of our study indicate that physicians should wherever possible explain the aims and the work of the hospice movement who should be their ally in a qualified commitment for the dying. It can be expected that the hospice movement will find a lot of sympathy in the population as 2 of its major aims--openness in communication and dying at home wherever possible--were shared by the vast majority of all interviewees: in case of incurable disease 92% wanted to be informed on their diagnosis, and 84% wanted to die at home or in their families home.

Euthanasia↗
PubMed2003

Active euthanasia and physician-assisted suicide: the German discussion.

The debate on legalization of active euthanasia in the Netherlands and Belgium and the refused legal right to choose the circumstances of Diana Pretty's own death are the last actual reasons for reconsidering the situation in Germany. Around the world heated debates have broken out on the topic of active euthanasia. Specialists in the field of 'forensic medicine' have taken full part in these discussions. The present survey from the point of view of forensic medicine begins with a look at current terminology and at the laws pertaining to euthanasia in Germany. These laws are then contrasted with actual practice, including a description of the increasing acceptance of active euthanasia by the German population. The main argument against legalization of active euthanasia is that its formal acceptance in law would cause the dam of restraint to burst, culminating in widespread misuse, as already seen in recent serial killings by nurses in hospitals and homes for the elderly around the world. Contrasted with this are the arguments for taking active steps at the end of life, including emotional considerations such as the revulsion against mechanized medicine and the fear of pain and rational arguments such as the necessity to end a 'life unworthy of life', to save medical costs, and obtaining prior consent in 'living wills'. Such considerations have put in jeopardy the moral integrity of the medical profession - and thus the layperson's trust in physicians--around the world. In Germany especially the history of mass killing during the Nazi era constitutes a fundamental argument against active euthanasia. As a consequence, in Germany active euthanasia will not receive legal sanction, although recommendations on rendering dying more bearable are permitted.

Attitude of Health Personnel↗
PubMed1999

[Students' attitudes to active euthanasia].

Attitude surveys in the Norwegian population show that an increasing majority support active euthanasia for patients with terminal disease. Among physicians, only a minority supports active euthanasia. Attitudes towards euthanasia were surveyed among students of medicine, law and psychology (n = 588, response rate 66%) with regard to a patient suffering from a painful, incurable and deadly or non-deadly disease, asking the doctor for help to die. To assess the strength of the students' attitude, the questions were presented either in a Christian context disapproving of euthanasia, in a humanistic context in favour, or in a neutral context-free form. 125 of 176 law students (71%), 134 of 216 psychology students (62%) and 71 of 196 medical students (36%) supported active euthanasia in cases of terminal disease. In cases of non-terminal disease, the corresponding percentages were 45%, 29% and 11%. 38% of the students with a Christian belief supported euthanasia in terminal disease while 79% of the humanists, 70% of those of another faith, and 65% of those without a definable faith did so. No significant gender difference was observed. 17% of the students stated that they were willing to perform euthanasia. No effect of context was observed. The results indicate stable and differentiated attitudes to the question of active euthanasia. One third of the medical students supported active euthanasia, which is twice as many as for physicians in general. Two thirds of the law and psychology students did so, which is similar to comparable age groups in the population.

Adult↗
PubMed2000

Surveys on attitudes to active euthanasia and the difficulty of drawing normative conclusions.

PURPOSE: To present surveys on active euthanasia and to discuss what normative conclusions can be drawn. METHODS: Two summary articles and 30 recent surveys on attitudes to active euthanasia are discussed. RESULTS: According to the first summary article, acceptance of active euthanasia among the public has stabilized around 65%; according to the second, almost 60% of physicians are in favour of legalizing active euthanasia. As for the 30 recent surveys, physicians are most often respondents. while the general public is surveyed in only three. The differences in attitudes are striking: 21-78% answered that active euthanasia should be legalized, and 14-51% rejected this idea. The core of the general problem of drawing normative conclusions from empirical data is first addressed; then we discuss the principles of autonomy and beneficence, which are often referred to in arguments for and against euthanasia.

Attitude of Health Personnel↗
PubMed2000

[Public opinion on active euthanasia. The results of a pilot project].

BACKGROUND AND OBJECTIVE: Despite eager public interest there have been few significant studies about the views of the German population on active euthanasia. It was our purpose to investigate, before undertaking a representative enquiry about this controversial and ethically sensitive topic, to what extent public opinion and the underlying norms, values and preferences can be adequately obtained by standardized data collection. COHORT AND METHODS: An interdisciplinary project group established a standardized written form of enquiry for measuring public opinion about active euthanasia. The test was performed on an anonymized convenience [corrected] sample of 110 persons living in North Germany. The questionnaires consisted of ten hypothetical cases, 11 potentially relevant viewpoints on likely decisions and eight frequently expressed arguments used in the debate for and against euthanasia. RESULTS: The reply rate to the questionnaire was 89% (n = 98; 37 men and 59 women, average age 39.5 [21-81] years). Agreement with active euthanasia in the various case examples ranged, according to context, from 85 to 93%. Active euthanasia was accepted by a clear majority, if preconditions of a voluntary decision by a mentally sound person and incurable, terminal disease (cancer) are cumulatively fulfilled. Otherwise it was rejected by most respondents. To a clear majority, active euthanasia implied both the chance that suffering would be shortened, but also the danger of misuse. Among the persons questioned those with professional experience of euthanasia were clearly more sceptical about active euthanasia than those without such experience. CONCLUSIONS: The standardized written questionnaire made it possible to obtain a differentiated picture of public opinion on active euthanasia. However, these data represent only a moment in the dynamic process of a norm being established within a society and must on no account be used as legitimizing active euthanasia by plebiscite.

Adult↗
PubMed2000

[Students' attitudes toward active euthanasia, assisted suicide and proposed amendments to the penal code].

BACKGROUND: Attitude surveys in the Norwegian population show a majority supporting active euthanasia for patients with terminal disease, while among physicians, only a minority do so. MATERIAL AND METHODS: Attitudes towards active euthanasia, assisted suicide and proposed alteration of section 235 (to no penalty for manslaughter on compassionate grounds) and repeal of section 236 (assisted suicide) were surveyed among students of medicine, law and psychology at the University of Oslo (n = 520, response rate 59%). The issue was a patient suffering from a painful, incurable and fatal or non-fatal disease, asking for help to die. RESULTS: 61% of the law students, 59% of the psychology students and 24% of the medical students supported active euthanasia in cases of terminal disease. For assisted suicide, the corresponding percentages were 69%, 64% and 35%, respectively. For alteration of section 235, 72%, 57% and 35% agreed; for repeal of section 236, 52%, 46% and 28%. Among students with a Christian faith, 30% supported active euthanasia in terminal disease and 39% did so for assisted suicide. For students of another faith or without a definable faith, the corresponding percentages were 57% and 65%, respectively. No significant gender difference was observed. Compared to a similar student survey made three years earlier, the results showed a significant decrease in support of active euthanasia of ten percentage points among students of medicine and law, but no change for students of psychology. INTERPRETATION: The study indicates stable and differentiated attitudes towards euthanasia with significantly greater (nearly ten percentage points) support of assisted suicide compared to active euthanasia for both terminal and non-terminal disease. This probably reflects a view of the patient's own right to participate in making decisions in a critical situation.

Adult↗
PubMed1991

Active euthanasia and forgoing life-sustaining treatment: can we hold the line?

Public sentiment in favor of permitting voluntary active euthanasia creates a dilemma for a bioethics rooted in a libertarian notion of autonomy. At stake in the active euthanasia debate is actually a question of power--the individual's assertion of sovereignty over the timing and circumstances of his or her own death. Also at stake is society's unwillingness to impose a conception of the good--and a good dying--on individuals whose personal values and conceptions of the good may differ. In order both to reject voluntary active euthanasia and to affirm the patient's right to forgo life-sustaining treatment, some societal conception of the good must be developed and agreed upon to counter unbridled claims of individual self-sovereignty over dying. Pragmatic arguments alone, such as the need to maintain confidence in the doctor-patient relationship, will not be sufficient.

Beneficence↗
PubMedDate not supplied

On the difference between physician-assisted suicide and active euthanasia.

Those who defend physician-assisted suicide often seek to distinguish it from active euthanasia, but in fact, the two acts face the same objections. Both can lead to abuse, both implicate the physician in the death of a patient, and both violate whatever objections there are to killing. Their moral similarity derives from the similar roles of the physician.

Coercion↗
PubMed1998

Active euthanasia and assisted suicide: a perspective from an American abortion and Dutch euthanasia scenario.

PURPOSE/OBJECTIVES: To discuss the critical issues involved in the legalization of active euthanasia and physician-assisted suicide. DATA SOURCES: Nursing, medical, legal, and ethics literature; newspaper articles; book chapters. DATA SYNTHESIS: The major terms employed in the discussion of active euthanasia and physician-assisted suicide are defined. The implications of the recent Supreme Court decision on these practices are outlined. The Dutch euthanasia and the American abortion scenarios are used as models for the interpretation of the effects of future legislation on such practices. CONCLUSIONS: Oncology nurses need to be cognizant of the crucial issues involved in the practices of active euthanasia and physician-assisted suicide and determine their philosophical stance regarding the practices. IMPLICATIONS FOR NURSING PRACTICE: If active euthanasia and physician-assisted suicide practices are legalized, oncology nurses will have to make decisions about their desired degree of involvement in acts that will end their patients' lives.

Abortion, Legal↗
PubMed2002

Voluntary active euthanasia and the nurse: a comparison of Japanese and Australian nurses.

Although euthanasia has been a pressing ethical and public issue, empirical data are lacking in Japan. We aimed to explore Japanese nurses' attitudes to patients' requests for euthanasia and to estimate the proportion of nurses who have taken active steps to hasten death. A postal survey was conducted between October and December 1999 among all nurse members of the Japanese Association of Palliative Medicine, using a self-administered questionnaire based on the one used in a previous survey with Australian nurses in 1991. The response rate was 68%. A total of 53% of the respondents had been asked by patients to hasten their death, but none had taken active steps to bring about death. Only 23% regarded voluntary active euthanasia as something ethically right and 14% would practice it if it were legal. A comparison with empirical data from the previous Australian study suggests a significantly more conservative attitude among Japanese nurses.

Adult↗
PubMed1995

Suicide and voluntary active euthanasia: why the difference in attitude?

It appears that the attitudes of health professionals differ towards suicide and voluntary active euthanasia. An acceptance of, if not an agreement with, voluntary active euthanasia exists, while there is a general consensus that suicide should be prevented. This paper searches for a working definition of suicide, to discover ethical reasons for the negative value that suicide assumes, and also to provide a term of reference when comparing suicide with euthanasia. On arriving at a working definition of suicide, it is compared with voluntary active euthanasia. An analysis of utilitarian and deontological considerations is provided and proves to be inconclusive with respect to the ethical principles informing the attitudes of professionals. Therefore, a search for other influences is attempted; this indicates that psychological influences inform attitudes to a greater degree than ethical principles.

Attitude of Health Personnel↗