Annals of palliative medicine · 2026
Changes in opinions on intentional or unintentional hastening of death from graduation to 6 years as a physician-a follow-up cohort study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Vettenmaa Milja, Piili Reetta P, Haapasalmi Saila, Metsänoja Riina, Kellokumpu-Lehtinen Pirkko-Liisa I, Lehto Juho T
Аннотация
BACKGROUND: Physicians' decision-making in end-of-life care involves many challenging ethical, legal, medical and psychological aspects including the possibility of hastening death. Hastened death is a complex ethical issue as it may cover both intentional assistance in death through euthanasia or physician-assisted suicide and the possibility of unintentional hastening of death through intensive management of suffering (the doctrine of double effect). The research question in our study was: Do views on unintentional or intentional hastening of death, and the factors behind them, change during the first 6 years as a physician?
METHODS: The same questionnaire, including hypothetical patient scenario, was answered by 227 Finnish physicians twice: at the time of their graduation in 2015 and after 6 years as a physician in 2021. The scenario presented in this study was a cancer patient requesting to increase his morphine dose to a potentially lethal level. The responders were asked whether they accepted this increment or not. Opinions on euthanasia, assisted suicide and several other attitudes were asked separately with a visual analogue scale. General life values and background factors were queried as well.
RESULTS: The proportion of physicians accepting the increase in morphine dosing was 25% in 2015 and 31% in 2021 (P=0.06). No significant change in the opinion about the reprehensibility of euthanasia and assisted suicide was found. However, withdrawal of life-sustaining treatments was considered less reprehensible in 2021. In regression analysis, male gender, being single, believing in God, not considering assisted suicide reprehensible, and not feeling burned out were associated with the acceptance of increased morphine dosing in 2021.
CONCLUSIONS: Acceptance of intentional or unintentional hastening of death presented in the survey did not significantly change after the first 6 years working as a physician, although a nonsignificant trend towards more accepting views was seen. Nevertheless, physicians' attitudes on this issue seemed to remain divided. Our results highlight the need for respectful discussion and education on ethics among medical profession to help physicians struggling with this demanding topic starting from medical school.
METHODS: The same questionnaire, including hypothetical patient scenario, was answered by 227 Finnish physicians twice: at the time of their graduation in 2015 and after 6 years as a physician in 2021. The scenario presented in this study was a cancer patient requesting to increase his morphine dose to a potentially lethal level. The responders were asked whether they accepted this increment or not. Opinions on euthanasia, assisted suicide and several other attitudes were asked separately with a visual analogue scale. General life values and background factors were queried as well.
RESULTS: The proportion of physicians accepting the increase in morphine dosing was 25% in 2015 and 31% in 2021 (P=0.06). No significant change in the opinion about the reprehensibility of euthanasia and assisted suicide was found. However, withdrawal of life-sustaining treatments was considered less reprehensible in 2021. In regression analysis, male gender, being single, believing in God, not considering assisted suicide reprehensible, and not feeling burned out were associated with the acceptance of increased morphine dosing in 2021.
CONCLUSIONS: Acceptance of intentional or unintentional hastening of death presented in the survey did not significantly change after the first 6 years working as a physician, although a nonsignificant trend towards more accepting views was seen. Nevertheless, physicians' attitudes on this issue seemed to remain divided. Our results highlight the need for respectful discussion and education on ethics among medical profession to help physicians struggling with this demanding topic starting from medical school.