[Survey of physicians' attitudes to terminal patients]

To explore the opinion of physicians about euthanasia and the treatment of dying patients.

A comparative survey.

We interviewed 38 family physicians (FP), 38 specialty physicians (SP) and 38 medical students (MS). The survey had 30 items, five of them about experience with terminal patients which were not used for the students.

Descriptive statistics and chi 2 or Fisher test to compare proportions between groups.

One hundred and two (89%) of the interviewed had a correct concept of euthanasia; 105 (92%) thought that life is holy and untouchable; 29 (25%) agreed there are persons more valuable than others, and four (4%) consider that some should die in certain situations. In relation to patients with brain death, 79 (69%) believed they should not receive futile treatment, but 42 (37%) said they should be attended until cardiac arrest occurred. All agreed with the need of the patients to receive comfort and peace, but only 49/76 (64%) of the physicians and 28 (74%) of the students were in favor of sending dying patients to their home. Nine FP (23%) and 14 SP (36%) stated that in many occasions they lacked elements to solve ethical dilemmas. Thirty six (32%) agreed with the use of passive euthanasia and 21 (18%) with active euthanasia; the latter was more frequent among students. Nine FP (24%) and 13 SP (34%) said they had exceeded therapy sometimes and 23 (61%) of the FP and 19 (50%) of the SP considered they had stopped treatment too early in some cases. We found no differences in regard to euthanasia between physicians and students (chi 2 = 0.32, p = 0.71) nor between the physicians with frequent vs occasional contact with terminal patients (Fisher = 0.13).

A third of the physicians agreed with some form of euthanasia but this frequency is smaller than that in other countries.