Attitude of doctors toward euthanasia in Delhi, India

Abstract

Introduction: Deliberation over euthanasia has been enduring for an extended period of time. On one end, there are populaces talking for the sacrosanctity of life and on the other end, there are those, who promote individual independence. All over the world professionals from different areas have already spent mammoth period over the subject. A large number of cases around the world have explored the boundaries of current legal distinctions, drawn between legitimate and nonlegitimate instances of ending the life. The term euthanasia was derived from the Greek words “eu” and “thanatos” which means “good death” or “easy death.” It is also known as mercy killing. Euthanasia literally means putting a person to painless death especially in case of incurable suffering or when life becomes purposeless as a result of mental or physical handicap. Objective: To study the attitude of doctors toward euthanasia in Delhi. Methodology: It was a questionnaire based descriptive cross-sectional study carried out between July 2014 and December 2014. The study population included Doctors from 28 hospitals in Delhi both public and private. Equal numbers of doctors from four specialties were included in this study (50 oncologists, 50 hematologists, 50 psychiatrists, and 50 intensivists). Demographic questionnaire, as well as the Euthanasia Attitude Scale (EAS), a 30 items Likert-scale questionnaire developed by (Holloway, Hayslip and Murdock, 1995) was used to measure attitude toward Euthanasia. The scale uses both positively (16 items) and negatively (14 items) worded statements to control the effect of acquiescence. The scale also has four response categories, namely “definitely agree,” “agree,” “disagree,” and “definitely disagree.” The total score for the EAS was generated by adding all the sub-scales (question's responses). The demographic questionnaire and EAS, a 30 items Likert-scale questionnaire developed by (Holloway, Hayslip and Murdock, 1995) was distributed among the study population to assess the clarity and adequacy of the questions. Reliability and content validity of the questionnaire were established. Reliability was calculated by “Cronbach Alpha” and the value computed was 0.839 the pilot study was conducted in a subset of 30 persons from the same study universe. Data were analyzed using Stata 11.2 and all the P < 0.05 were considered as statistically significant. Association of categorical variables among the groups was compared by using Chi-square/Fisher's exact test. Student's t-test was used to compare mean values in the two independent groups, and one-way ANOVA was used for more than two groups. A total of 200 questionnaires were returned out of 400, giving a response rate of 50%. Analysis and Results: Our study provided the evidence that all doctors who responded to the questionnaire knew term euthanasia. This could be due to the fact that these professionals are in close association with issues pertaining to euthanasia in their day to day work. No significant difference seen in the attitude of doctors of different age group toward euthanasia, although younger doctors endorse robustly for euthanasia. This may be because younger doctors are open for addressing these debatable issues proactively. We found no association between gender and attitude toward euthanasia in our study. Conclusion: It is evident from our study that oncologists, hematologists, psychiatrist, and intensivists do not support active euthanasia at all. There is a strong voice in support of voluntary passive euthanasia among psychiatrists and intensivists in our study. However, oncologists and hematologists are not in favor of passive euthanasia.

Facing Death: Attitudes toward Physician-Assisted End of Life among Physicians Working at a Tertiary-Care-Hospital in Israel

“…These findings indicate the daily dilemmas physicians face when on the one hand, they are committed to protecting the sanctity of life, and yet, on the other hand, they are committed to alleviating the patient’s suffering while respecting their autonomy and choice. We found no differences between men and women regarding attitudes toward euthanasia which is in line with other studies [ 21 , 22 ]. As for the positive relationship between seniority and attitudes toward euthanasia, previous studies have found that euthanasia is more favorable among older, veteran physicians who have had previous encounters with terminal patients and are more likely to provide patients with lethal drugs if asked to by terminal patients seeking to end their lives [ 21 , 23 ].…”

Medicine Facing Death: Attitudes Toward Physician-Assisted End of Life – A Cross-Sectional Study

“…These ndings indicate the dilemmas physicians face, when on the one hand, they are committed to protecting the sanctity of life, and yet, on the other hand, they are interested in alleviating the patient's suffering while respecting their autonomy and choice. We found no signi cant differences between men and women regarding attitudes toward euthanasia which is in line with other studies (21,22). As for the positive relationship between seniority and attitudes toward euthanasia, previous studies have found that euthanasia is more favorable among older, veteran physicians who have had previous encounters with terminal patients, and are more likely to provide patients with lethal drugs if asked to by terminal patients seeking to end their lives (21,23).…”

Assisted dying and voluntary euthanasia: awareness and perception among health care professionals in a tertiary care centre, South India

“…In context to advanced medical directive (AMD), previously a study conducted in India reported that 60% of the doctors and 59% of the nurses had a view that 'there should be some legal avenue where the patient can pre-authorize his/her death'. 8 However, in the present study, there was lack of awareness among the health professionals about AMD.…”

“…5,10 However, on the contrary, one of the study did not support euthanasia and considered it as unethical since we are emotional and care driven society and probably it is still considered a taboo to discuss death and end of life. 8 Also, the fear of its misuse is high due to 'rampant corruption and mass commercialization' as quoted by supreme court of India. Majority (65.3%) of the participants perceived that AD and VE is helping a person with a terminal illness to die.…”