BMJ 1994;308:1332-34 (21 May)

Papers

Attitudes among NHS doctors to requests for euthanasia

B J Ward, P A Tate, East Barnwell Health Centre, Cambridge CB5 8SP. a

a Department of Anatomy, Cambridge University, Cambridge CB2 3DY Correspondence to: Dr

Abstract

Objectives : To explore NHS doctors' attitudes to competent patients' requests for euthanasia and to estimate the proportion of doctors who have taken active steps to hasten a patient's death. Design - Anonymous postal questionnaire, with no possibility of follow up. The survey was conducted from December 1992 to March 1993.
Subjects : All (221) general practitioners and 203 hospital consultants in one area of England.
Results : 273 doctors responded to a question on whether a patient had ever asked them to hasten death. Of these, 163 had been asked to; 124 of these had been asked to take active steps to hasten death; 38 of 119 (32%) of these had complied with such a request (95% confidence interval 23% to 40%). This proportion represented 12% of all those who returned a completed questionnaire and 9% of all those who had been sent a questionnaire (95% confidence interval 6.3% to 11.7%). A larger proportion of the respondents (142/307 (46%)), however, would consider taking active steps to bring about the death of a patient if it was legal to do so.
Conclusions : Many doctors face difficult decisions about euthanasia. For the benefit of both patients and doctors euthanasia should be discussed more openly.

Clinical implications

  • Clinical implications

  • Few data exist in Britain on the incidence of euthanasia or on doctors' attitudes towards euthanasia

  • This study showed that almost half of the doctors surveyed had been asked by a patient to take active steps to hasten death

  • A third of the doctors who had been asked to take active steps had complied with a patient's request

  • Almost half of all doctors would consider taking active steps to hasten a patient's death if it became legal to do so.

  • British law on euthanasia is not satisfactory for either patients or doctors, and euthanasia should be discussed more openly


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Article

Dutch experience of monitoring euthanasia
Bregje D Onwuteaka-Philipsen, Agnes van der Heide, Martien T Muller, Mette Rurup, Judith A C Rietjens, Jean-Jacques Georges, Astrid M Vrakking, Jacqueline M Cuperus-Bosma, Gerrit van der Wal, and Paul J van der Maas
BMJ 2005 331: 691-693. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

  • Draper, H., Ives, J., Pall, H., Smith, S., Damery, S., Wilson, S. (2009). Reporting end-of-life practice: can we trust doctors to be honest?. Palliat Med 23: 673-674  
  • (2009). Legalisation of euthanasia or physician-assisted suicide: survey of doctors' attitudes. Palliat Med 23: 205-212  
  • Catania, C., Zagonel, V., Fosser, V., La Verde, N., Bertetto, O., Iacono, C., Venturini, M., Radice, D., Adamoli, L., Boccardo, F. (2008). Opinions concerning euthanasia, life-sustaining treatment and acceleration of death: results of an Italian Association of Medical Oncology (AIOM) survey. Ann Oncol 19: 1947-1954 [Abstract] [Full text]  
  • Mobeireek, A F, Al-Kassimi, F, Al-Zahrani, K, Al-Shimemeri, A, al-Damegh, S, Al-Amoudi, O, Al-Eithan, S, Al-Ghamdi, B, Gamal-Eldin, M (2008). Information disclosure and decision-making: the Middle East versus the Far East and the West. J. Med. Ethics 34: 225-229 [Abstract] [Full text]  
  • Kitching, M., Stevens, A. J., Forman, L. (2008). Views regarding physician-assisted suicide: a study of medical professionals at various points in their training. Clin Ethics 3: 27-33 [Abstract] [Full text]  
  • Neil, D A, Coady, C A J, Thompson, J, Kuhse, H (2007). End-of-life decisions in medical practice: a survey of doctors in Victoria (Australia). J. Med. Ethics 33: 721-725 [Abstract] [Full text]  
  • Grossoehme, D. H., Ragsdale, J. R., McHenry, C. L., Thurston, C., DeWitt, T., VandeCreek, L. (2007). Pediatrician Characteristics Associated With Attention to Spirituality and Religion in Clinical Practice. Pediatrics 119: e117-e123 [Abstract] [Full text]  
  • Onwuteaka-Philipsen, B. D., Fisher, S., Cartwright, C., Deliens, L., Miccinesi, G., Norup, M., Nilstun, T., van der Heide, A., van der Wal, G., for the European End-of-Life (EURELD) Consortium, (2006). End-of-Life Decision Making in Europe and Australia: A Physician Survey.. Arch Intern Med 166: 921-929 [Abstract] [Full text]  
  • Seale, C. (2006). National survey of end-of-life decisions made by UK medical practitioners. Palliat Med 20: 3-10 [Abstract]  
  • Keown, J (2006). Mr Marty's muddle: a superficial and selective case for euthanasia in Europe. J. Med. Ethics 32: 29-33 [Abstract] [Full text]  
  • Onwuteaka-Philipsen, B. D, van der Heide, A., Muller, M. T, Rurup, M., Rietjens, J. A C, Georges, J.-J., Vrakking, A. M, Cuperus-Bosma, J. M, van der Wal, G., van der Maas, P. J (2005). Dutch experience of monitoring euthanasia. BMJ 331: 691-693 [Full text]  
  • Jansen-van der Weide, M. C., Onwuteaka-Philipsen, B. D., van der Wal, G. (2005). Granted, Undecided, Withdrawn, and Refused Requests for Euthanasia and Physician-Assisted Suicide. Arch Intern Med 165: 1698-1704 [Abstract] [Full text]  
  • Magnusson, R S (2004). Euthanasia: above ground, below ground. J. Med. Ethics 30: 441-446 [Abstract] [Full text]  
  • Magnusson, R. S. (2004). "Underground Euthanasia" and the Harm Minimization Debate. J Law Med Ethics 32: 486-495  
  • Chao, D., Chan, N., Chan, W. (2002). Euthanasia revisited. Fam Pract 19: 128-134 [Abstract] [Full text]  
  • Morita, T., Akechi, T., Sugawara, Y., Chihara, S., Uchitomi, Y. (2002). Practices and Attitudes of Japanese Oncologists and Palliative Care Physicians Concerning Terminal Sedation: A Nationwide Survey. JCO 20: 758-764 [Abstract] [Full text]  
  • Dearling, J., Irwin, M. H K (2001). Euthanasia. BMJ 323: 809-809 [Full text]  
  • Emanuel, E. J., Fairclough, D., Clarridge, B. C., Blum, D., Bruera, E., Penley, W. C., Schnipper, L. E., Mayer, R. J. (2000). Attitudes and Practices of U.S. Oncologists regarding Euthanasia and Physician-Assisted Suicide. ANN INTERN MED 133: 527-532 [Abstract] [Full text]  
  • Nilstun, T., Melltorp, G., Hermeren, G. (2000). Surveys on attitudes to active euthanasia and the difficulty of drawing normative conclusions. Scand J Public Health 28: 111-116 [Abstract]  
  • Willems, D. L., Daniels, E. R., van der Wal, G., van der Maas, P. J., Emanuel, E. J. (2000). Attitudes and Practices Concerning the End of Life: A Comparison Between Physicians From the United States and From the Netherlands. Arch Intern Med 160: 63-68 [Abstract] [Full text]  
  • Wolfe, J., Fairclough, D. L., Clarridge, B. R., Daniels, E. R., Emanuel, E. J. (1999). Stability of Attitudes Regarding Physician-Assisted Suicide and Euthanasia Among Oncology Patients, Physicians, and the General Public. JCO 17: 1274-1274 [Abstract] [Full text]  
  • Griffiths, P. (1999). Physician-Assisted Suicide and Voluntary Euthanasia: is it time the UK law caught up?. Nurs Ethics 6: 107-117 [Abstract]  
  • Magnusson, R. S., Ballis, P. H. (1999). The response of health care workers to AIDS patients' requests for euthanasia. Journal of Sociology 35: 312-330 [Abstract]  
  • Emanuel, E. J., Daniels, E. R., Fairclough, D. L., Clarridge, B. R. (1998). The Practice of Euthanasia and Physician-Assisted Suicide in the United States: Adherence to Proposed Safeguards and Effects on Physicians. JAMA 280: 507-513 [Abstract] [Full text]  
  • Muskin, P. R. (1998). The Request to Die: Role for a Psychodynamic Perspective on Physician-Assisted Suicide. JAMA 279: 323-328 [Abstract] [Full text]  
  • van der Maas, P. J., van der Wal, G., Haverkate, I., de Graaff, C. L.M., Kester, J. G.C., Onwuteaka-Philipsen, B. D., van der Heide, A., Bosma, J. M., Willems, D. L. (1996). Euthanasia, Physician-Assisted Suicide, and Other Medical Practices Involving the End of Life in the Netherlands, 1990-1995. NEJM 335: 1699-1705 [Abstract] [Full text]  
  • Asch, D. A. (1996). The Role of Critical Care Nurses in Euthanasia and Assisted Suicide. NEJM 334: 1374-1379 [Abstract] [Full text]  
  • Onwuteaka-Philipsen, B. D., Muller, M. T., van der Wal, G., van Eijk, J. T. M., Ribbe, M. W. (1995). Attitudes of Dutch General Practitioners and Nursing Home Physicians to Active Voluntary Euthanasia and Physician-Assisted Suicide. Arch Fam Med 4: 951-955 [Abstract]  
  • Green, G. (1995). Legalised suicide may increase openness in the doctor-patient relationship. BMJ 310: 1467c-1467 [Full text]  
  • Grisolia, J. S. (1994). Physicians and Their Patients' Suicides. JAMA 272: 1410-1410 [Abstract]  
  • Smith, A M, Twycross, R, Madeley, P, Gilbert, J, Ventafridda, V, Thomson, H J, Fergusson, A, Saunders, P, Finlay, I G, Norris, P, Ward, B, Tate, P (1994). Euthanasia: Present law protects doctors and patients. BMJ 309: 471a-471 [Full text]  
  • Rodway, A, Collins, K, Gilhooly, M L M, Murray, K, Twycross, R, Helme, T, Davis, A (1994). Euthanasia Precise definitions are needed. BMJ 309: 52-53 [Full text]  
  • Heintz, A P M (1994). Euthanasia: can be part of good terminal care. BMJ 308: 1656-1656 [Full text]  



Access jobs at BMJ Careers
Whats new online at Student 

BMJ