Increasing Physician Support for PAS

Just reporting this week…I will leave it to readers to comment beyond my brief comments here…

Just before Christmas, my email inbox included a link (registration may be needed to access) from Medscape to a slideshow describing some results of a survey of 21,000 physicians, 17,000 in the US and 4,000 in Europe.  There was a comparison of 2014 results with prior results from 2010.  In the intervening 4 years:

  • The share of respondents answering “yes” to the question “should physician-assisted suicide be allowed?” increased to 54% from 46%.  The “no” group had declined from 41% to 31%.
  • In 2014, “yes/no” responses in Europe to the same question were 41% each, compared to 54/31% in the US.  (Most of the remainder said, “it depends,” which I take to be a qualified “yes.”)
  • Support for PAS was greatest in Germany and the UK (47% yes,33% no), least in Spain (36/48%), and intermediate in Italy and France, with a slight plurality for “yes” in both of those nations.
  • The question was asked, “Would you give life-sustaining therapy if you considered it futile?”  This strikes me as one of those poorly-worded survey questions, but about half said “it depends,” a third said “no,” and a fifth said “yes.”  Perhaps not surprising, emergency physicians were a bit more prone to lean toward the side of treating than oncologists or cardiologists.
  • 86% said that life sustaining treatment is NOT being withdrawn “too soon.”
  • About a quarter would continue treatment in defiance of a family’s wishes if they thought there was a reasonable chance of success.  Another quarter would not defy the family, and fully half left the door open (“it depends”).
  • “Is it right to provide intensive treatment to a newborn who will either die soon” or survive “with an objectively terrible quality of life?”—about 30% yes, 30% no, 40% ambivalent.  A poor question that makes huge assumptions about the ability of the physician to judge quality of life.
  • 44% said “yes” and 15% “it depends” in response to the question, “would you perform an abortion if it were against your personal beliefs?”  I find that response a stunning statement about the importance of professional conscience.
  • About a quarter responded “yes” and a third “it depends” to a question asking whether late-term abortions should be legal.
  • A quarter (maybe I should say “only” a quarter) would definitely prefer using scarce resources for a younger patient over an older one based on age alone.
  • One-quarter of US physicians and fully half of EU physicians surveyed would withhold information about a terminal diagnosis “to bolster a patient’s attitude.”
  • 60% would at least consider withholding such information at the request of a patient’s family.
  • 9% said they would deny a potentially more effective treatment if a patient’s insurance would not pay for it; another 22% would consider it.
  • Three-quarters say they would NOT soft-pedal a discussion of treatment risks, in an effort to secure a patient’s consent, if they thought the treatment would be effective.  (This speaks to the “therapeutic misconception” in some cancer treatments, experimental or otherwise.)
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