緩和ケアと医学

抽象的な

Effect of Knowing Patients' Wishes and Health Profession on Euthanasia

Mireille Lavoie, Gaston Godin, Lydi-Anne Vézina-Im, Danielle Blondeau, Isabelle Martineau and Louis Roy

Background: Respecting patients’ autonomy is often put forward as one of the main reasons why certain health professionals are favourable to euthanasia. Few studies have compared whether nurses and physicians hold different beliefs regarding euthanasia. The objective of the study was to experimentally test whether knowing patients’ wishes and profession can affect health professionals’ intentions and beliefs regarding performing euthanasia. Methods: This a 2×2 random factorial design study (experimental conditions: patient’s wishes known or not; professions: nurses or physicians). A vignette describing the case of a person near death was used to manipulate knowledge of patient’s wishes. Random samples of nurses and physicians from the province of Québec, Canada, were obtained using random digit tables. Samples were weighted according to the domains of practice and medical specialties included in the study. Data were collected by means of an anonymous questionnaire based on an extended version of the Theory of Planned Behaviour. Results: Overall, the response rate was 41.3%. There was a significant known wishes×profession interaction for intention, F (3, 266)=7.38, p=0.0070 and only a known wishes effect for the other beliefs, F (6, 256)=2.86, p=0.0102. Scores for intention and the other beliefs were lower among physicians who were exposed to the vignette where patient’s wishes were unknown. Conclusion: Knowing patients’ wishes regarding euthanasia appears to influence physicians, but not nurses. This is the first study to test whether knowledge of patient’s wishes and profession have an impact on health professionals’ intention and beliefs regarding euthanasia.