Rebecca Reichel, Sophia Helen Adam, Hans-Jörg Ehni, Florian Junne, Anne Herrmann-Werner, Andreas J Fallgatter, Stephan Zipfel, Rebecca Erschens
{"title":"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。","authors":"Rebecca Reichel, Sophia Helen Adam, Hans-Jörg Ehni, Florian Junne, Anne Herrmann-Werner, Andreas J Fallgatter, Stephan Zipfel, Rebecca Erschens","doi":"10.1192/bjo.2024.731","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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 In February 2020, the previous German law prohibiting PAS was repealed.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.</p><p><strong>Aims: </strong>To explore the ethical and moral perspectives of medical students and physicians when making individual decisions regarding PAS.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>A total of <i>N</i> = 1478 participants completed the survey. Of these, <i>n</i> = 470 (32%) stated that they would refuse the request, whereas <i>n</i> = 582 (39%) would probably refuse, <i>n</i> = 375 (25%) would probably agree and <i>n</i> = 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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":null,"pages":null},"PeriodicalIF":3.9000,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Perspectives on physician-assisted suicide in mental healthcare: results of a survey of physicians and medical students.\",\"authors\":\"Rebecca Reichel, Sophia Helen Adam, Hans-Jörg Ehni, Florian Junne, Anne Herrmann-Werner, Andreas J Fallgatter, Stephan Zipfel, Rebecca Erschens\",\"doi\":\"10.1192/bjo.2024.731\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Aims: </strong>To explore the ethical and moral perspectives of medical students and physicians when making individual decisions regarding PAS.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>A total of <i>N</i> = 1478 participants completed the survey. Of these, <i>n</i> = 470 (32%) stated that they would refuse the request, whereas <i>n</i> = 582 (39%) would probably refuse, <i>n</i> = 375 (25%) would probably agree and <i>n</i> = 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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":9038,\"journal\":{\"name\":\"BJPsych Open\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-08-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BJPsych Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1192/bjo.2024.731\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJPsych Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1192/bjo.2024.731","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
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.
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.