Attitudes Toward Euthanasia and Physician-Assisted Suicide Among Italian Primary Care Physicians

Abstract

The public debate about euthanasia and assisted suicide is less pronounced in Italy than in other countries, and data about this topic are lacking. The aim of this study was to investigate primary care physicians' experience in requests for and opinions about euthanasia and/or assisted suicide for terminally ill patients and the relationship between attitudes and professional variables. Three-hundred thirty-six general practitioners completed the Euthanasia Questionnaire to assess attitudes toward euthanasia and/or assisted suicide and the Maslach Burnout Inventory to examine burnout symptoms. The rate of requests for euthanasia or assisted suicide was low (11% and 4.5%, respectively). Only a minority of the physicians endorsed euthanasia and/or assisted suicide. Agreement with the practice of euthanasia/assisted suicide was correlated with non-Catholic religious affiliation, inexperience in treating terminally ill patients, and the burnout dimension of depersonalization. The fact that professional as well as individual factors (e.g., inexperience, non-Catholic affiliation, burnout) were associated with favorable attitudes toward euthanasia and/or assisted suicide underscores the need to examine the problem as a complex phenomenon involving the dyadic patient-doctor relationship.

Differences in physician-reported practice in palliative sedation therapy

“…This finding is consistent with previous empirical studies suggesting that physicians' values significantly influence the choices in end-of-life treatment [7,9,10,16,21], and highlights the strong need for a more patientcentered approach in selecting the treatment most suitable for the patient with refractory suffering. Thus physicians should first clarify the patients' and families' preferences on the basis of the patients' and families' values, not their own values, and share the decision-making process in choosing the treatment options.…”

“…The questionnaire (available from the author) was developed by the author on the basis of a literature review and discussion with four palliative care physicians and three palliative care nurses [2,3,4,5,6,7,8,9,12,13,16,20,21,23,24,25,26]. The validity of the questionnaire was confirmed by independent review by another palliative care expert.…”

Psychiatric Morbidity and Burnout in the Medical Profession: An Italian Study of General Practitioners and Hospital Physicians

“…In fact, psychiatric morbidity has been associated with burnout symptoms, and, in turn, burnout has been reported to strongly influence, in a negative way, the attitudes of the doctors towards their patients [25]and, possibly, the quality of for the patients care [17]. …”

Physician-Perceived Contradictions in End-of-Life Communication: Toward a Self-Report Measurement Scale

“…For example, while the U.S. culture gives much emphasis to truth-telling practices, this is not a common rule in other countries, where the disclosure of a serious illness may be viewed as disrespectful, impolite, or even harmful to a patient (Dalla-Vorgia et al, 1992;Searight & Gafford, 2005). In Italy, for instance, until recently it was considered reasonable to hide diagnoses and prognoses from seriously ill patients to maintain their hope (Grassi et al, 1999). Still today, truth-telling practices are meeting cultural resistance in Italian patients and physicians (Surbone et al, 2004).…”