Exploring the Beliefs Underlying Attitudes to Active Voluntary Euthanasia in a Sample of Australian Medical Practitioners and Nurses: A Qualitative Analysis

Abstract

A qualitative study explored beliefs about active voluntary euthanasia (AVE) in a sample (N = 18) of medical practitioners and nurses from Australia, where AVE is not currently legal. Four behaviors relating to AVE emerged during the interviews: requesting euthanasia for oneself, legalizing AVE, administering AVE to patients if it were legalized, and discussing AVE with patients if they request it. Using thematic analysis, interviews were analyzed for beliefs related to advantages and disadvantages of performing these AVE behaviors. Medical practitioners and nurses identified a number of similar benefits for performing the AVE-related behaviors, both for themselves personally and as health professionals. Benefits also included a consideration of the positive impact for patients, their families, and the health care system. Disadvantages across behaviors focused on the potential conflict between those parties involved in the decision making process, as well as conflict between one's own personal and professional values.

Multifaceted Nature of Euthanasia

“…Furthermore, opponents of euthanasia are often worried about drifting toward a ''slippery slope,'' that is, an extension of legal euthanasia from people with full mental capacity to people who cannot make independent decisions on ending their lives, for example, children or comatose patients. 4,14,18,23,[25][26][27] Possible reduction of people's control over decisions regarding their end-of-life care is seen as a further reason to resist euthanasia, 28 whereas respect for people's autonomy is one of the main reasons for positive attitudes toward euthanasia and its legalization. Supporters perceive euthanasia as a means of alleviating suffering.…”

“…For them, the quality of life is more important than its length. 4,15,19,20,25,26,28 Interpreting results of previous studies is complicated by the varying definitions and classifications of euthanasia used. One classification, based on the level of involvement, distinguishes between active euthanasia (termination of a person's life by a deliberate act, such as injection of medication) and passive euthanasia (termination by inaction).…”

“…One classification, based on the level of involvement, distinguishes between active euthanasia (termination of a person's life by a deliberate act, such as injection of medication) and passive euthanasia (termination by inaction). 1,4,6,26 Another classification, based on the expression of a person's will, distinguishes between voluntary euthanasia (termination following a patient's explicitly expressed desire for the act), 1,4,22,28 involuntary euthanasia (without the patient's request), and nonvoluntary euthanasia (in cases where the patient is incapable of consenting). 1,4,15 In this study, euthanasia is defined as a deliberate act intended to terminate the life of a person following his/her explicit request.…”

“…1,4,15 In this study, euthanasia is defined as a deliberate act intended to terminate the life of a person following his/her explicit request. 1,28,29 The purpose of this study was to contribute to the ongoing debate by elucidating nurses' rarely explored perceptions of euthanasia and its legalization in Finland.…”

Joining a right-to-die society: Motivation, beliefs and experiences

“…Carmel (1999) suggests that what doctors want for themselves may differ from what they are prepared to do for their patients. Also, much attitude research is quantitative (White, Wise, Young, & Hyde, 2008), tending to avoid examination of underlying personal beliefs that inform attitudes. Miccinesi, Fischer, Paci, Onwuteaka-Philipsen, Cartwright, van der Heide et al (2005) in a large, internationally comparative survey of doctors in Australia and several European countries showed greater support for assisted dying amongst non-religious doctors, with the highest levels of support found in countries where assisted dying was already legalised (the Netherlands, Belgium and Switzerland) or had been briefly legalised (Australia), with least support for legalisation amongst French doctors and amongst physicians trained in pain management and palliative care.…”