Attitudes of UK doctors towards euthanasia and physician-assisted suicide: A systematic literature review
From Palliative Medicine
Actor Sir Patrick Stewart and author Ian McEwan are just a couple of the stars who have pledged their support to a campaign calling for a change in the law on assisted dying in the UK. Dignity in Dying, which aims to legalise the choice of assisted dying for terminally ill, mentally competent adults, said the trio of new patrons were among more than 30 additional high profile supporters of their campaign in the last 12 months.Sir Patrick said: “We have no control over how we arrive in the world but at the end of a life we should have control over how we leave it.” The issue has been a subject for great public debate over recent years particularly sparked by the support for Dignitas a Swiss assisted dying group that helps those with terminal illness and severe physical and mental illnesses to die with dignity, assisted by qualified doctors and nurses.
This paper reviews studies from 2 decades that assess the attitudes of UK doctors concerning active, voluntary euthanasia (AVE) and physician-assisted suicide (PAS). It examines the trail of legislation and concludes from the data studied, UK doctors appear to oppose the introduction of AVE and PAS, This position seems to conflict with that of the UK public. Increased religiosity is seen as the strongest predictor of a negative attitude towards assisted death. The provision of palliative care is seen by most doctors as the important thing to focus on, reducing suffering and the need for assisted dying.
Objectives: To review studies over a 20-year period that assess the attitudes of UK doctors concerning active, voluntary euthanasia (AVE) and physician-assisted suicide (PAS), assess efforts to minimise bias in included studies, determine the effect of subgroup variables (e.g. age, gender) on doctors’ attitudes, and make recommendations for future research. Data sources: Three electronic databases, four pertinent journals, reference lists of included studies.
Review methods: Literature search of English articles between January 1990 and April 2010. Studies were excluded if they did not present independent data (e.g. commentaries) or if they related to doctors outside the UK, patients younger than 18 years old, terminal sedation, withdrawing or withholding treatment, or double-effect. Quantitative and qualitative data were extracted.
Results: Following study selection and data extraction, 15 studies were included. UK doctors oppose the introduction of both AVE and PAS in the majority of studies. Degree of religiosity appeared as a statistically significant factor in influencing doctors’ attitudes. The top three themes in the qualitative analysis were the provision of palliative care, adequate safeguards in the event of AVE or PAS being introduced, and a profession to facilitate AVE or PAS that does not include doctors.
Conclusions: UK doctors appear to oppose the introduction of AVE and PAS, even when one considers the methodological limitations of included studies. Attempts to minimise bias in included studies varied. Further studies are necessary to establish if subgroup variables other than degree of religiosity influence attitudes, and to thoroughly explore the qualitative themes that appeared.
McCormack, R., Clifford, M., & Conroy, M. (2011). Attitudes of UK doctors towards euthanasia and physician-assisted suicide: A systematic literature review Palliative Medicine DOI: 10.1177/0269216310397688