A profile of the belief system and attitudes to end-of-life decisions of senior clinicians working in a National Health Service Hospital in the United Kingdom

Abstract

There is evidence from outside the United Kingdom to show that physicians’ religious beliefs influence their decision making at the end of life. This UK study explores the belief system of consultants, nurse key workers and specialist registrars and their attitudes to decisions which commonly must be taken when caring for individuals who are dying. All consultants ( N = 119), nurse key workers ( N = 36) and specialist registrars ( N = 44) working in an acute hospital in the north-east of England were asked to complete a postal questionnaire. In all, 65% of consultants, 67% of nurse key workers and 41% of specialist registrars responded. Results showed that consultants’ religion and belief systems differed from those of nurses and the population they served. Consultants and nurses had statistically significant differences in their attitudes to common end of life decisions with consultants more likely to continue hydration and not withdraw treatment. Nurses were more sympathetic to the idea of physician-assisted suicide for unbearable suffering. This study shows the variability in belief system and attitudes to end of life decision making both within and between clinical groups. This may have practical implications for the clinical care given and the place of care. The personal belief system of consultants was not shown to affect their overall attitudes to withdrawing life-sustaining treatment or physician-assisted suicide.

Attitudes of UK doctors towards euthanasia and physician-assisted suicide: A systematic literature review

“…[4][5][6][7][8][9][10][11]13,[17][18][19][20][21][22][23] Figure 1 presents the full study selection process. Two early studies 13,22 presented the data in the format of a letter.…”

“…a Pugh 7 Physician-assisted suicide (euthanasia), should be allowed for patients who have 'unbearable' suffering. b…”

“…Furthermore, many additional studies have since taken place. [4][5][6][7][8][9][10][11] The Select Committee's review did, however, provide an opportunity for organisations representing doctors to formally express their views on assisted dying, where the bill defined 'assisted dying' as 'the attending physician, at the patient's request, either providing the patient with the means to end the patient's life or if the patient is physically unable to do so ending the patient's life'. 2 Among these were the views of The Academy of Medical Royal Colleges (AMRC) published via the report of The Royal College of Physicians in London, and the stance expressed was a neutral one.…”

Influencers of ethical beliefs and the impact on moral distress and conscientious objection

“…This suggestion is supported in a British study that shows nurses' attitudes toward assisted suicide to be affected by their spiritual beliefs. 27 …”

Análisis de la toma de decisiones al final de la vida desde una perspectiva teórica contemporánea

“…encontraron que la raza muestra una influencia estadísticamente significativa en el tipo de decisiones predominantes, siendo la raza hispana más sensible que la raza blanca (estadounidense) a solicitar la prolongación de la vida y a instaurar medidas de soporte vital 38 . Otros han encontrado que los pacientes encuentran dificultades en procesar gran cantidad de información, no entienden los términos médicos y pueden confundirse o asustarse durante las discusiones con el médi-co, así como aseguran que hay diferencias muy marcadas entre la importancia que se le da a los efectos secundarios de los tratamientos entre los médicos y los pacientes 39 . Situaciones similares se encontraron en nuestro estudio, y se ilustran con algunas de las narraciones y citas textuales.…”