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A Survey of Physician Attitudes

Robyn S. Shapiro, JD; Arthur R. Derse, MD, JD; Mark Gottlieb, PhD; David Schiedermayer, MD; Mary Olson

Arch Intern Med. 1994;154(5):575-584.

Abstract
Background
In the United States, few studies have examined important variables in physician attitudes toward the practice of euthanasia, such as the patient's underlying disease, mental capacity, and age, and the physician's specialty and religion. We administered a case-based survey to analyze the impact of such specific variables on physician attitudes toward the practice.

Methods
A four-section survey solicited (1) physician responses to three hypothetical cases in which patients requested euthanasia; (2) physicians' general opinions about euthanasia and how its legalization might affect them personally and professionally; and (3) demographic information. Analysis focused on physicians' characteristics as they related to their responses to the various aspects of euthanasia elicited in the survey. Univariate and multivariate analyses, using logistic regression, were performed.

Results
Completed and analyzable surveys were returned by 740 physicians. We found that physicians felt more comfortable with euthanasia requests from non-decisional, nonterminal patients who had left advance directives than they did with requests from decisional patients suffering from grave illnesses or injuries, or from decisional patients who had early signs of a progressive but nonlethal neurologic disease. We also found that physicians' specialties and religions correlated with their responses to the hypothetical cases and with their generalized attitudes toward euthanasia.

Conclusions
Given the disparity in responding physicians' attitudes toward euthanasia, along with the fact that values based on religious affiliation or profession may underlie many physicians' opposition to the practice, we conclude that if euthanasia is to be legalized, safe-guards protective of patients and physicians must be incorporated.

(Arch Intern Med. 1994;154:575-584)

Author Affiliations
From the Center for the Study of Bioethics (Attorney Shapiro and Dr Derse and Ms Olson) and Departments of Family Medicine (Dr Gottlieb) and Medicine (Dr Schiedermayer), Medical College of Wisconsin, Milwaukee.

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