The intention to hasten death: a survey of attitudes and practices of surgeons in Australia

Abstract

Objective To determine attitudes among surgeons in Australia to assisted death, and the proportion of surgeons who have intentionally hastened death with or without an explicit request. Design Anonymous, cross‐sectional, mail‐out survey between August and November 1999 Participants 683 out of 992 eligible general surgeons (68.9% response rate). Main outcome measures Proportion of respondents answering affirmatively to questions about administering excessive doses of medication with an intention to hasten death. Results 247 respondents (36.2%; 95% CI, 32.6%–39.9%) reported that, for the purpose of relieving a patient's suffering, they have given drugs in doses that they perceived to be greater than those required to relieve symptoms with the intention of hastening death. More than half of these (139 respondents; 20.4% of all respondents; 95% CI, 17.4%–23.6%) reported that they had never received an unambiguous request for a lethal dose of medication. Of all respondents, only 36 (5.3%; 95% CI, 2.9%–6.1%) reported that they had given a bolus lethal injection, or had provided the means to commit suicide, in response to an unambiguous request. Conclusions More than a third of surgeons surveyed reported giving drugs with an intention to hasten death, often in the absence of an explicit request. However, in many instances, this may involve the use of an infusion of analgesics or sedatives, and such actions may be difficult to distinguish from accepted palliative care, except on the basis of the doctor's self‐reported intention. Legal and moral distinctions based solely on a doctor's intention are problematic.

End-of-life decisions in medical practice: a survey of doctors in Victoria (Australia)

“…At the same time, there had been a slight increase in the proportion of doctors who report having administered drugs with the intention of hastening death. On this issue, we also note a point of agreement between our findings and the results obtained by Douglas et al 7 in a study to “determine attitudes among surgeons in Australia to assisted death, and the proportion of surgeons who have intentionally hastened death”. Those authors reported that 36% of surgeons surveyed responded affirmatively to the following question:…”

The Kuhse-Singer Euthanasia Survey: Why it Fails to Undermine the Slippery Slope Argument — Comparing Apples and Apples

“…21 It is noteworthy that a more recent survey of surgeons by Douglas et al revealed even higher levels of voluntary and nonvoluntary euthanasia. 22 For the purposes of the discussion at hand, the results of this survey are less significant than the findings of the Kuhse-Singer survey. The respondents to the Kuhse-Singer survey came from 27 different medical disciplines.…”

Ascribing intentions in clinical decision-making

“…Some empirical research on this issue has seemed to support this suspicion. For example, a recent study by Douglas et al 6 found that physicians in Australia had difficulty deciding whether a consequence of their interventions (the death of their patient) was an intended or unintended event 11. To our knowledge, no empirical work has been done on the possible causes of the alleged uncertainty of these intention–ascriptions.…”

“…They have claimed that clinical intentions are frequently “ambiguous” and multiple 4 5 6. They have also suggested that clinicians frequently have difficulty identifying what their intentions are in a given case.…”