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  • Online Edition Volume 5(3)has been added Last update March 18, 2010 -10:15 PM

    • Should the Patient be Given Freedom and Assistance in Committing Suicide? A Study of Knowledge and Attitude of Senior Health Care Providers Towards Practice of Voluntary Euthanasia Under Law

    Background: Euthanasia or Physician’s assisted suicide is an emotive and socioculturally sensitive subject. It has many moral and legal aspects to debate. Concepts of healthcare professionals about its meanings and implications have been reported vague and unclear Healthcare professionals are primarily concerned with end of life situations and are generally felt responsible to elucidate to this issue.
    Objective: This study was undertaken to assess knowledge and attitude of senior healthcare providers working in a public sector tertiary care hospital towards practice of euthanasia as medical treatment modality.
    Subjects and Methods: It was a cross-sectional study. Using purposive sampling technique 53 (n=53) senior healthcare providers belonging to various departments of a public sector tertiary care institution were assessed by direct interviewing for their knowledge and attitude towards euthanasia. Important attributes of the subjects were analyzed for odds ratio for their statistical significance.
    Results:  Majority 86.79% respondents had simple knowledge of euthanasia and 77.35% subjects expressed negative attitude towards euthanasia. Only 30.1% subjects possessed comprehensive knowledge of euthanasia. Simple knowledgeably and strong advocacy of the subjects was statistically associated with the seniority category (OR= 3.25 & 3) and also correlated with increasing experience. Non-Advocates (100%) justified for being not permitted in Islam and Advocates (100%) declared it a matter of basic human right of the patients.
    Conclusions: Majority of healthcare professionals hold limited knowledge and diverse opinions. There is need for more scientific work and discussions at medical and other forms to enable our health system to address this issue. 
    Key words: Euthanasia, Terminal care, Mercy Killing. 

    Introduction

    According to the International Task Force on Euthanasia and Assisted Suicide, euthanasia is the act of intentionally, knowingly and directly causing the death of a patient. If someone other than the person who dies performs the last act, euthanasia has occurred .1,2 Euthanasia is voluntary in which a clearly competent person makes a voluntary and enduring request to be helped to die.3,4 euthanasia is also defined under terms as Non-voluntary, Involuntary, by act and  by omission [means intentionally causing death by not providing necessary and ordinary (usual and customary) care for food, water, etc ]. Euthanasia is being debated for its lawful practice at medical and other forums since early decades of the 20th century but history mentions of ancient Greeks and Romans who favored suicide in cases when no relief could be offered to dyeing. In 1938, first euthanasia society of America was established in USA. The point of view of the supportive group was that people under certain miserable, incurable terminal conditions should be given choice in dyeing provided it is undertaken in human & painless way. Legalization of euthanasia was attempted through ballot in Washington, in 1991 but failed. It was again attempted in 1994 in Oregon state USA and this time the voters approved it as “death with dignity act”. Since then many groups in the developed world are working for the same cause.
    Purpose of these groups is to disseminate information to the public by all law full means about nature, purpose and need of euthanasia and to foster its general adoption. They work not only for legalization of voluntary euthanasia but for non-voluntary euthanasia (putting to death non-volunteers beyond the help of medical science) as well. Euthanasia activists believe in that conditions demanding euthanasia occur universally and not infrequently “physician assisted suicide” is practiced to some how or other. So it is better to legalize it so that it could be practiced under controlled guidelines and policy.

    		  

    Authors Name
    Syed Arshad Sabir

    Farooq Ahmad

    Fatima Khalid

    Hina Hafeez

    Shahwana

    Yasir Shafi.

    Practice of euthanasia is a health and public policy phenomenon. It has many unaddressed and controversial medical, moral, religious and legal aspects. In our country there are many health related issues with socio-cultural implications like organ transplant for which a national policy is yet to decide. Eventually it is the patients and families who suffer. Although euthanasia. as a public policy phenomenon is under debate since  long in western societies but it is very scant  at scientific or  public forums in the country. Sanders K, & Chaloner C had identified euthanasia as a highly emotive and contentious subject and enough lack of clarity about its concepts among professionals and the public .5 Healthcare professional’s understanding about euthanasia must be clear & holistic. Patients, families, religion and law are major partners on the subject of euthanasia but the Doctors were primarily concerned with end of life situations and felt responsible to elucidate this subject.
    Dialogue and debate was  an ethical and scientific way to know the unknown aspects of such problems and also to conclude rationally. This study was aimed not only to sensitize healthcare professionals but also to scientifically translate their opinions, concerns and experiences who were supposed to be exposed to such situations during their professional work. Underlying purpose of study was to generate first hand information on the subject from our healthcare setup for its possible future utilization.  

    The objective the study was to “assess knowledge and attitude of senior healthcare providers working in a public sector tertiary care hospital towards practice of euthanasia as medical treatment modality”.

    Subjects and Methods

    It was a descriptive cross-sectional study. By using purposive sampling technique 55 senior healthcare providers belonging to various specialties/departments of a tertiary care public sector medical institution at Rawalpindi were accessed. Fifty three (n=53) of them who gave informed consent were examined by an interviewer administered based questionnaire. Questionnaire contained both close and open-ended questions. Study was conducted during July-2006 to March 2007. Data were entered into computers and was analyzed on SPSS version.10

    Results

    Total number of 53 subjects (n=53) were explored. Mean age of the respondents was 46.2 y (95%CI 44.7-47.6), ranging 30-57yeras. Average experience of the study subjects was 18.4Y (95%CI 16.9-19.8) ranging 7-33years. Male to female ratio was approx.: 3:1. Twenty eight subjects belonged to senior category (Professors & associate Professors) while 25 belonged to junior category (Assistant professors).  Majority 46 (86.79%) respondents had simple knowledge of euthanasia and 41(77.35%) subjects expressed negative attitude about use of euthanasia as a medical treatment. Only 16 (30.1%) possessed comprehensive knowledge of euthanasia. (Table 1&II). Knowledge & attitude of the subjects was analyzed under demographic profile (Table.III). Only 04 (9%) out of 46 informed subjects acquired this knowledge during undergraduate studies and remaining acquired it afterwards.

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