Factors that Influence End-Of-Life Decision Making Amongst Attending Physicians

Background: Medical advances prolong life and treat illness but many patients have chronically debilitating conditions that prevent them from making end-of-life (EOL) decisions for themselves. These situations are difficult to navigate for both patient and physician. This study investigates physicians’ feelings and approach toward EOL care, physician-assisted suicide (PAS), and euthanasia. Methods: An anonymous, self-administered online survey was distributed through the New Jersey Medical School servers and American College of Surgeons forums. The survey presented clinical EOL vignettes and subjective questions regarding PAS and euthanasia. Results: We obtained 142 responses from attending physicians. Respondents were typically male (61%), married (85%), identified as Christian (54%), had more than 20 years of experience (55%), and worked at a university hospital (57%). Religious beliefs and years of work experience seemed to be significant contributors in EOL decision making, whereas gender and medical specialty were not significantly influential. Conclusion: Factors such as years of work experience and religious belief may influence medical professionals’ opinions about PAS and euthanasia and their subsequent actions regarding EOL care. In many cases, the boundaries are blurred and require further study before concrete conclusions can be made.

1. Chao, D, Chan, NY, Chan, WY. Euthanasia revisited. Fam Pract. 2002;19(2):128-134.
Google Scholar | Crossref | Medline2. Emanuel, EJ, Onwuteaka-Philipsen, BD, Urwin, JW, Cohen, J. Attitudes and practices of euthanasia and physician-assisted suicide in the United States, Canada, and Europe. J Am Med Assoc. 2016;316(1):79-90.
Google Scholar | Crossref | Medline | ISI3. Lapierre, S, Castelli Dransart, D, St-Amant, K, Dubuc, G, Houle, M, Lacerte, MM, et al. Religiosity and the wish of older adults for physician-assisted suicide. Religions. 2018;9(3):66.
Google Scholar | Crossref4. Thurston, A . Physician-assisted death: A selected annotated bibliography. Law Libr J. 2019;111:31.
Google Scholar5. Kuhse, H, Singer, P, Rickard, M, Baume, P, Clark, M. End‐of‐life decisions in Australian medical practice. Med J Aust. 1997;166(4):191-196.
Google Scholar | Crossref | Medline | ISI6. Meier, DE, Emmons, CA, Wallenstein, S, Quill, T, Morrison, RS, Cassel, CK. A national survey of physician-assisted suicide and euthanasia in the United States. N Engl J Med. 1998;338(17):1193-1201.
Google Scholar | Crossref | Medline | ISI7. Van Der Maas, PJ, Van Delden, JJM, Pijnenborg, L, Looman, CWN. Euthanasia and other medical decisions concerning the end of life. Lancet. 1991;338(8768):669-674.
Google Scholar | Crossref | Medline | ISI8. Glynn, K . Double effect: Getting the argument right: Physician-assisted suicide. Commonweal. 1999;126:36-39.
Google Scholar9. Bharmal, A, Morgan, T, Kuhn, I, Wee, B, Barclay, S. Palliative and end-of-life care and junior doctors': A systematic review and narrative synthesis. BMJ Support Palliat Care. 2019.
Google Scholar | Crossref | Medline10. Stempsey, WE . The role of religion in the debate about physician-assisted dying. Med Healthc Philos. 2010;13(4):383-387.
Google Scholar | Crossref | Medline11. Traina, CL . Religious perspectives on assisted suicide. The Journal of criminal law & criminologySpring. 1998;88(3):1147-1154.
Google Scholar | Crossref | Medline12. Smith-Stoner, M . End-of-life preferences for atheists. J Palliat Med. 2007;10(4):923-928.
Google Scholar | Crossref | Medline13. Hinkka, H, Kosunen, E, Metsänoja, R, Lammi, UK, Kellokumpu-Lehtinen, P. Factors affecting physicians' decisions to forgo life-sustaining treatments in terminal care. J Med Ethics. 2002;28(2):109-114.
Google Scholar | Crossref | Medline | ISI14. Christakis, N. A., Asch, D. A. Physician characteristics associated with decisions to withdraw life support. Am J Publ Health. 1995;85(3):367-372.
Google Scholar | Crossref | Medline | ISI15. Gibson, R . The case for euthanasia and physician-assisted suicide. Australian Humanist. 2013;109:11-14.
Google Scholar16. De Beer, T, Gastmans, C, Dierckx De Casterlé, B. Involvement of nurses in euthanasia: A review of the literature. J Med Ethics. 2004;30(5):494-498.
Google Scholar | Crossref | Medline

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