对精神医疗中医生协助自杀的看法:对医生和医科学生的调查结果。

IF 3.9 3区 医学 Q1 PSYCHIATRY
BJPsych Open Pub Date : 2024-08-07 DOI:10.1192/bjo.2024.731
Rebecca Reichel, Sophia Helen Adam, Hans-Jörg Ehni, Florian Junne, Anne Herrmann-Werner, Andreas J Fallgatter, Stephan Zipfel, Rebecca Erschens
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引用次数: 0

摘要

背景:医生协助自杀(PAS)通常与姑息治疗中常见的严重身体疾病有关。然而,患有精神疾病的人也可能因病情严重而无法忍受生活。2020 年 2 月,德国废除了之前禁止 PAS 的法律。严重精神疾病患者越来越有可能向医生提出临终关怀请求。目的:探讨医学生和医生在做出临终关怀个人决定时的伦理道德观点:方法:对德国的医学生和医生进行匿名数字调查。向参与者展示了一个长期抑郁症患者请求临终关怀的案例。参与者决定是否提供 PAS,并对理论论据进行评估。我们采用了广义序数回归和定性分析来解释数据:共有 N = 1478 名参与者完成了调查。其中,n = 470 人(32%)表示会拒绝该请求,n = 582 人(39%)可能会拒绝,n = 375 人(25%)可能会同意,n = 57 人(4%)肯定会同意。以病人为中心的论点,如自我决定权,增加了同意的可能性。由于担心对长期抑郁症患者实施临时辅助治疗可能会削弱人们对医疗专业的信任,因此提供临时辅助治疗的意愿有所下降:结论:对于慢性抑郁症患者,参与者考虑提供临时辅助治疗的意愿相对较低。本研究强调了医学伦理理论论点和更广泛的公众讨论的重大影响,强调了对精神疾病患者的临终关怀进行伦理讨论的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perspectives on physician-assisted suicide in mental healthcare: results of a survey of physicians and medical students.

Background: Physician-assisted suicide (PAS) is typically associated with serious physical illnesses that are prevalent in palliative care. However, individuals with mental illnesses may also experience such severity that life becomes intolerable. In February 2020, the previous German law prohibiting PAS was repealed. Patients with severe mental illnesses are increasingly likely to approach physicians with requests for PAS.

Aims: To explore the ethical and moral perspectives of medical students and physicians when making individual decisions regarding PAS.

Method: An anonymised digital survey was conducted among medical students and physicians in Germany. Participants were presented with a case vignette of a chronically depressed patient requesting PAS. Participants decided on PAS provision and assessed theoretical arguments. We employed generalised ordinal regression and qualitative analysis for data interpretation.

Results: A total of N = 1478 participants completed the survey. Of these, n = 470 (32%) stated that they would refuse the request, whereas n = 582 (39%) would probably refuse, n = 375 (25%) would probably agree and n = 57 (4%) would definitely agree. Patient-centred arguments such as the right to self-determination increased the likelihood of consent. Concerns that PAS for chronically depressed patients might erode trust in the medical profession resulted in a decreased willingness to provide PAS.

Conclusions: Participants displayed relatively low willingness to consider PAS in the case of a chronically depressed patient. This study highlights the substantial influence of theoretical medical-ethical arguments and the broader public discourse, underscoring the necessity of an ethical discussion on PAS for mental illnesses.

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来源期刊
BJPsych Open
BJPsych Open Medicine-Psychiatry and Mental Health
CiteScore
6.30
自引率
3.70%
发文量
610
审稿时长
16 weeks
期刊介绍: Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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