Doctor's Survey Supports Medically Assisted Dying

Victorian doctor's survey supports medically assisted dying, Jan. 12, 2008.

The December issue of the prestigious Journal of Medical Ethics published end- of-life decisions in medical practice: a survey of doctors in Victoria, Australia. This survey was a replication, with some variations, of a survey conducted in 1987 by Helga Kuhse and Peter Singer, which was one of the first empirical studies of doctors’ attitudes. Helga was a co-author of this study, the principal investigator being Dr David Neil.

The 1987 study found 60% support for the legalization of voluntary euthanasia, compared to 58% for the current study, a difference that is not statisically significantly different, but rather an indication of sustained support by a majority for change. A number of studies in other states and countries have shown similar support.

Fifty-nine percent of responding doctors had received requests to hasten death by withholding or withdrawing treatment, and 43 percent had received requests at least once to hasten death by administering lethal drugs.

Thirty-five per cent of doctors “had administered medication with the intention of hastening that patient’s death”. This is a very similar figure to the 36 percent of Australian surgeons who had acted similarly in a 2001 survey.

Ninety-four percent of doctors believed requests to withdraw treatment as sometimes reasonable, while 65 percent believed requests to hasten death by administration of drugs to be sometimes reasonable.

It was clear from the results and the comments made by doctors that opinions were markedly polarized. Total opposition was commonly based on moral and religious commitments, whereas support was based on a right to die with dignity, and on seeing such action as a hallmark of a civilized and humane society.

Of note was the significant disagreement as to what actually constituted euthanasia.

A majority (62 percent) of respondents indicated that where palliative measures will foreseeably shorten the patient’s life to some degree, this should not count as euthanasia.

The confusion revealed by this study is confirmation of the wisdom of DWDV to change its name, and drop the use of the word “euthanasia”. The word has no accepted single definition, covers a wide range of medical actions which are intended to provide palliation of suffering; and some non-medical actions. Some are considered legal, others are not.

If a medical act is palliative in nature, and is requested by a person with intolerable and relievable suffering, then it should be acceptable in practice and in law. It seems a majority of doctors agree.

D A Neil, C A J Coady, J Thompson and H Kuhse, Journal of Medical Ethics 2007;33:721-725.