Identifying practical clinical problems in active euthanasia: A systematic literature review of the findings in countries where euthanasia is legal

Kono, Madoka; Arai, Nana; Takimoto, Yoshiyuki

doi:10.1017/s1478951522001699

Cited by 8 publications

(5 citation statements)

References 57 publications

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“…This suggests that these physicians want to increase the patient's awareness of all options for palliative care, including those aimed at prolonging or shortening life. This might be especially true for those designating autonomy as the primary goal of their treatment (Craig & Dzeng, 2018 ; Kono et al., 2023 ; Mohammed et al., 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, despite these discrepancies, approximately one third of Polish neurologists expressed readiness to discontinue LSMs in response to a patient's request. This stance highlights the willingness of some physicians to address end‐of‐life issues, even if it entails legal implications, potentially stemming from their respect for patient autonomy as a guiding principle (Craig & Dzeng, 2018 ; Kono et al., 2023 ). Our questionnaire did not concurrently explore the neurologists' hypothetical decisions regarding euthanasia or PAS implementation.…”

Section: Discussionmentioning

confidence: 99%

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One third of physicians discuss exit strategies with patients with amyotrophic lateral sclerosis: Results from nationwide surveys among German and Polish neurologists

Barć,

Finsel,

Helczyk

et al. 2024

Brain and Behavior

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ObjectiveThis paper examines neurologists’ approaches to exit strategies (ESs), such as euthanasia and physician‐assisted suicide, in patients with amyotrophic lateral sclerosis (PALS) in two European countries.MethodsIn a nationwide anonymous survey, we collected responses from 237 Polish and 228 German neurologists, focusing on their practices and beliefs about ESs, as well as their viewpoints on life‐sustaining measures (LSMs) (percutaneous endoscopic gastrostomy, non‐invasive, and invasive ventilation). To analyze the data, we employed statistical methods, including Mann–Whitney U, Kruskal–Wallis, chi‐square tests, Spearman's rank correlation, and multiple regression analysis.ResultsOne third of the neurologists initiated the discussion about ESs with PALS. Half were ready to have this conversation upon patient's request. Age, gender, religiousness, and nationality were closely associated with this approach. One in 9 neurologists received a request to terminate an LSM, whereas 1 in 10 to implement an ES. German neurologists and palliative care trainees acquired both demands more commonly. Neurologists quoted a low quality of life, decreased mood, and being a burden to the family/closest ones as primary reasons for a wish to hasten death among PALS. Although the majority expressed a willingness to terminate an LSM at a request of the patient, most opposed the legalization of euthanasia. Younger and less religious individuals were more likely to favor accepting euthanasia.ConclusionNeurologists vary significantly in their approaches to terminal care. Complex relationships exist among personal indices, shared beliefs, and current practices.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

One third of physicians discuss exit strategies with patients with amyotrophic lateral sclerosis: Results from nationwide surveys among German and Polish neurologists

Barć,

Finsel,

Helczyk

et al. 2024

Brain and Behavior

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“…MAiD, either by euthanasia or assisted suicide, is legal in The Netherlands, Belgium, Luxembourg, Switzerland, Canada, Spain, New Zealand, Germany and Colombia, 5,6 along with some state jurisdictions in the USA and Australia. 6 In 2020, Germany overturned an assisted suicide prohibition on grounds of unconstitutionality.…”

Section: International Contextmentioning

confidence: 99%

“…8 Luxembourg, Switzerland, The Netherlands and Belgium currently allow MAiD for mental disorders. 5,6 (Note that Bill C-7 and associated legislative materials use the term 'mental illness'. The term 'mental disorder' is commonly used in major diagnostic classification systems.…”

Section: International Contextmentioning

confidence: 99%

Medical assistance in dying for mental illness: a complex intervention requiring a correspondingly complex evaluation approach

Bastidas-Bilbao,

Castle,

Gupta

et al. 2024

Br J Psychiatry

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Medical assistance in dying for mental illness as a sole underlying medical condition (MAiD MI-SUMC) is a controversial and complex policy in terms of psychosocial and ethical medical practice implications. We discuss the status of MAiD MI-SUMC in Canada and argue for the use of the UK Medical Research Council's framework on complex interventions in programme evaluations of MAiD MI-SUMC. It is imperative to carefully and rigorously evaluate the implementation of MAiD MI-SUMC to ensure an understanding of the multiple facets of implementation in contexts permeated by unique social, economic, cultural and historical influences, with a correspondingly diverse array of outcomes. This requires a complexity-informed programme evaluation focused on context-dependent mechanisms and stakeholder experiences, including patients, service providers and other people affected by the policy. It is also important to consider the economic impact on health and social welfare systems. Such evaluations can provide the data needed to guide evidence-informed decision-making that can contribute to safer implementation and refinement of MAiD MI-SUMC.

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“…Additionally, policymakers can use this knowledge to inform the development of guidelines and regulations surrounding euthanasia, ensuring that they reflect the diverse perspectives and values of medical students and healthcare professionals. 29,30…”

Section: Practical Implicationsmentioning

confidence: 99%

HEXACO personality traits, spiritual intelligence, and views on euthanasia among medical students: a moderation analysis

Khosravi,

Farhangi

2024

Mental Wellness

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The ethical dilemma of euthanasia presents a significant challenge in medical practice. The attitudes of medical students toward euthanasia can be shaped by a variety of factors, such as their personal beliefs, values, and personality traits. This study explored the intricate relationship between personality traits, as outlined by the model, and medical students’ attitudes toward euthanasia, with a particular focus on the potential moderating effect of spiritual intelligence. In this cross-sectional study, 219 medical students from Zahedan, Iran, including 85 males and 134 females, were selected in 2022 using a non-random convenience sampling method. Participants provided socio-demographic information, including age, gender, and medical degree. They were also evaluated using the spiritual intelligence self-report inventory, the 24-item brief HEXACO inventory, and the euthanasia attitude scale (EAS). Data analysis was conducted using SPSS software version 29 and included both descriptive statistics (frequency, mean, and standard deviation) and inferential statistics (independent t-test, analysis of variance, Pearson correlation coefficient, and hierarchical linear regression). The findings revealed a significant positive correlation between the personality trait of openness to experience and favorable attitudes toward euthanasia. In contrast, there was a negative correlation between EAS scores and spiritual intelligence, as well as the honesty-humility dimension of personality. Furthermore, regression analysis indicated that spiritual intelligence moderated the relationship between EAS scores and the associated personality traits. The study underscores the importance of understanding how HEXACO personality traits and spiritual intelligence influence medical students’ attitudes toward euthanasia. This insight is vital for medical educators and policymakers in creating educational programs that foster critical thinking, empathy, and ethical decision-making in future healthcare professionals. Additionally, this knowledge can guide the formulation of euthanasia policies that respect the diverse viewpoints and values within the medical community.

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Identifying practical clinical problems in active euthanasia: A systematic literature review of the findings in countries where euthanasia is legal

Cited by 8 publications

References 57 publications

One third of physicians discuss exit strategies with patients with amyotrophic lateral sclerosis: Results from nationwide surveys among German and Polish neurologists

One third of physicians discuss exit strategies with patients with amyotrophic lateral sclerosis: Results from nationwide surveys among German and Polish neurologists

Medical assistance in dying for mental illness: a complex intervention requiring a correspondingly complex evaluation approach

HEXACO personality traits, spiritual intelligence, and views on euthanasia among medical students: a moderation analysis

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