Perceptions of Portuguese Doctors Regarding Hastened Death Scenarios: A Cross-Sectional Study

Authors

  • Eva Pereira Faculty of Medicine. University of Porto. Porto.
  • Sílvia Marina Faculty of Medicine. University of Porto. Porto. CINTESIS - Center for Health Technology and Services Research. Porto. https://orcid.org/0000-0003-4808-9000
  • Miguel Ricou Faculty of Medicine. University of Porto. Porto. CINTESIS - Center for Health Technology and Services Research. Porto.

DOI:

https://doi.org/10.20344/amp.17290

Keywords:

Decision Making, Euthanasia/legislation & jurisprudence, Portugal, Suicide, Assisted/legislation & jurisprudence

Abstract

Introduction: A growing number of countries have legalized the process of hastening death. At a time when laws decriminalizing hastened death have been passed in the Portuguese Parliament, the development of research related with decision making regarding this issue is of crucial importance. This study seeks to evaluate, in a sample of Portuguese doctors, whether the presentation of clinical vignettes changes the agreement with the practice of hastened death compared with general scenarios.
Material and Methods: A questionnaire was distributed among academic physicians from medical schools across Portugal to assess their level of agreement or disagreement with the practice of hastened death. The questionnaire included eight standard cases and eight clinical vignettes framed under conditions defined by law for the practice of hastened death. Differences were analyzed using the t-Student test for paired samples.
Results: There were statistically significant differences in five scenarios (t = 3.46; p < 0.05; t = 2.47; p < 0.05; t = 4.28; p < 0.05; t = 3.38; p < 0.05; t = 3.66; p < 0.05) with greater agreement concerning the clinical vignettes. The highest acceptance was found in the requests made by adults with terminal and incurable illnesses.
Conclusion: Agreement increased when the clinical vignette was presented in comparison with the respective standard for most of the cases of hastened death presented.

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References

Ricou M, Azevedo L, Silva S da. Determinantes na opinião sobre eutanásia em amostra de médicos portugueses. Rev Iberoam Bioética. 2019:1-19.

World Medical Association.WMA Medical Ethics Manual. 3rd ed. 2015. [cited 2021 Feb 18]. Available from: https://www.wma.net/wp-content/uploads/2016/11/Ethics_manual_3rd_Nov2015_en.pdf.

Ricou M, Wainwright T. The psychology of euthanasia: why there are no easy answers. Eur Psychol. 2019;24:243-56.

Marina S, Costa-Maia I, Ricou M. Definição do conceito de morte antecipada em Português. Acta Med Port. 2019;32:474.

Instituto Nacional de Estatística. Tábuas de mortalidade. 2019. [cited 2021 Jan 26]. Available from: https://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_destaques&DESTAQUESdest_boui=354419871&DESTAQUEStema=55466&DESTAQUESmodo=2.

Felix ZC, da Costa SF, Alves AM, de Andrade CG, Duarte MC, de Brito FM. Eutanásia, distanásia e ortotanásia: revisão integrativa da literatura. Cien Saude Colet. 2013;18:2733-46.

Marina S, Wainwright T, Ricou M. The role of psychologists in requests to hasten death: a literature and legislation review and an agenda for future research. Int J Psychol. 2021;56:64-74.

Vilches L. On eutanasia. Rev Psicol. 2001;X:117-87.

Congreso de los Diputados. Boletín Oficial de Las Cortes Generales. Proposición de Ley Orgánica de Regulación de La Eutanasia. 2021. [cited 2021 Mar 23]. Available from: http://www.comunidad-tdah.com/contenido/images/tdah_proposicion_pp.pdf.

Belgian Ministry of Justice. Belgian Law on Euthanasia. 2014. [cited 2020 Dec 22]. Available from: ttp://www.ejustice.just.fgov.be/cgi_loi/change_lg.pl?language=fr&la=F&table_name=loi&cn=2014022803.

Regional Euthanasia Review Committees (RTE). Euthanasia Code 2018. [cited 2020 Dec 23]. Available from: https://www.euthanasiecommissie.nl/uitspraken/brochures/brochures/euthanasiecode/2018/euthanasia-code-2018.

Chambre des Députés L. Loi du 16 Mars 2009 sur l’euthanasie et l’assistance au suicide. Jahr Wiss Ethik. 2009:609-19.

Pereira J. Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls. Curr Oncol. 2011;18:38-45.

Regional Euthanasia Review Committees. Regional Euthanasia Review Committees: Annual Report 2018. 2018. [cited 2020 Dec 23]. Available from: www.euthanasiecommissie.nl.

Minister of Health, Welfare and Sport and the Minister of Security and Justice of Netherlands. Letter of 12 October 2016 from the Minister of Health, Welfare and Sport and the Minister of Security and Justice to the House of Representatives on the government position on ‘completed life. 2016. [cited 2020 Dec 22]. Available from: https://www.government.nl/documents/letters/2016/10/12/the-government-position-on-completed-life.

Verhagen E, Sauer PJ. The Groningen Protocol - Euthanasia in Severely Ill Newborns. N Engl J Med. 2005;352:959-62.

CNECV [Conselho Nacional de Ética para as Ciências da Vida]. Decreto N.o 109/XIV “Regula as Condições Em Que a Morte Medicamente Assistida Não é Punível e Altera o Código Penal.”; 2021:1-19. [cited 2021 Feb 18]. Available from: https://app.parlamento.pt/webutils/docs/doc.pdf?path=6148523063446f764c324679626d56304c334e706447567a4c31684a566b786c5a79394562324e31625756756447397a51574e3061585a705a47466b5a564268636d786862575675644746794c325978597a466b4d7a42694c5467304d7a4d744e4459305a533169597a46684c5759784e4755354d4445774d445a695979356b62324e34&fich=f1c1d30b-8433-464e-bc1a-f14e901006bc.docx&Inline=true.

Mullet E, Neto F, Pinto C, Raich R, Munoz Sastre MT, Sorum P. The acceptability of ending a patient’s life: a France–Portugal–Spain comparison. Death Stud. 2014;38:28-35.

Teisseyre N, Mullet E, Sorum PC. Under what conditions is euthanasia acceptable to lay people and health professionals? Soc Sci Med. 2005;60:357-68.

Guedj M, Gibert M, Maudet A, Muñoz Sastre MT, Mullet E, Sorum PC. The acceptability of ending a patient’s life. J Med Ethics. 2005;31:311-7.

Dany L, Baumstarck K, Dudoit E, Duffaud F, Auquier P, Salas S. Determinants of favourable opinions about euthanasia in a sample of French physicians. Psychosocial. BMC Palliat Care. 2015;14:1-7.

de Groot JW. The right to live and to die. J Clin Oncol. 2018;36:920-2.

Lee JE, Kim JH, Park CH, Gwak DW, Kim CH, Park D, et al. Are safe guards at trampoline parks safe enough? Medicine . 2019;98:e18137.

Kendrick LM, Hudgell D, Hellman A, Weaver MS. Attending to total pain in juvenile Huntington disease: a case report informed by narrative review of the literature. J Palliat Care. 2019;34:205-7.

Rodgers C, Field HL, Shakin Kunkel EJ. Countertransference issues in termination of life support in acute quadriplegia. Psychosomatics. 1995;36:305-9.

Regional Euthanasia Review Commitees. Dutch Regional Euthanasia Review Committees: 2015 Annual Report, Case 2015-59. 2015. [cited 2021 Mar 20]. Available from: https://english.euthanasiecommissie.nl/documents/publications/annual-reports/2002/annual-reports/annual-reports.

Regional Euthanasia Review Commitees. Dutch Regional Euthanasia Review Committees: 2016 Annual Report, Case 2016-44. 2016. [cited 2021 Mar 20]. Available from: https://english.euthanasiecommissie.nl/the-committees/documents/publications/annual-reports/2002/annual-reports/annual-reports.

Regional Euthanasia Review Commitees. Dutch Regional Euthanasia Review Committees: 2017 Annual Report, Case 2017-42. 2017. [cited 2021 Mar 21]. Available from: https://english.euthanasiecommissie.nl/documents/publications/annual-reports/2002/annual-reports/annual-reports.

Dyer C. Paralysed man will ask judges to let a doctor end his life. BMJ. 2013;346:2537.

Chen X, Ma X, Zou C. Phenotypic spectrum and genetic analysis in the fatal cases of Schaaf-Yang syndrome: two case reports and literature review. Medicine . 2020;99:e20574.

Terman S. To live long enough to warm the hearts of others: reflections on informing my patient about a peaceful way to die. Narrat Inq Bioeth. 2016;6:102-5.

Logue MD, Effken JA. Validating the personal health records adoption model using a modified e-Delphi. J Adv Nurs. 2013;69:685-96.

Streiner DL, Norman GR, Cairney J. Health measurement scales: a practical guide to their development and use. Cambridge: Oxford University Press; 2015.

Kline RB. Principles and practice of structural equation modeling. New York: Guilford Publications; 2015.

Singh S, Pai DR, Sinha NK, Kaur A, Kyaw Soe HH, Barua A. Qualities of an effective teacher: what do medical teachers think? BMC Med Educ. 2013;13:1.

Published

2022-10-12

How to Cite

1.
Pereira E, Marina S, Ricou M. Perceptions of Portuguese Doctors Regarding Hastened Death Scenarios: A Cross-Sectional Study. Acta Med Port [Internet]. 2022 Oct. 12 [cited 2024 Jul. 25];36(2):105-12. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/17290

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Section

Original