Assisted dying in Swedish healthcare: a qualitative analysis of physicians' reasoning about physician-assisted suicide.

IF 1.6 Q2 ETHICS Monash Bioethics Review Pub Date : 2024-06-01 Epub Date: 2024-07-26 DOI:10.1007/s40592-024-00202-5
Anna Lindblad, Niklas Juth, Ingemar Engström, Mikael Sandlund, Niels Lynøe
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Abstract

To explore Swedish physicians' arguments and values for and against physician-assisted suicide (PAS) extracted from the free-text comments in a postal survey. A random selection of approximately 240 physicians from each of the following specialties: general practice, geriatrics, internal medicine, oncology, surgery and psychiatry. All 123 palliative care physicians in Sweden. A qualitative content analysis of free-text comments in a postal questionnaire commissioned by the Swedish Medical Society in collaboration with the Karolinska Institute in Stockholm. The total response rate was 59.2%. Of the 933 respondents, 1107 comments were provided. The free-text comments entailed both normative and factual arguments for and against PAS. The analysis resulted in two main categories: (1) "Safe implementation of PAS is unachievable" (with subcategories "Criteria of PAS difficult to fulfil" and "PAS puts societal norms and values at risk") and (2) "The role of PAS in healthcare" (with subcategories "No medical need for PAS", "PAS is not a task for physicians", "No ethical difference to other end-of-life decisions" and "PAS is in the patient's best interest"). The respondents brought up well-known arguments from academic and public debate on the subject. Comments from physicians against PAS were more often emotionally charged and used devices like dysphemisms and slippery-slope arguments.

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瑞典医疗保健中的协助死亡:对医生协助自杀推理的定性分析。
从一项邮寄调查的自由文本评论中提取瑞典医生支持和反对医生协助自杀(PAS)的论点和价值观。从以下各专科随机抽取约 240 名医生:全科、老年病科、内科、肿瘤科、外科和精神病科。瑞典所有 123 名姑息关怀医生。瑞典医学会与斯德哥尔摩卡罗林斯卡研究所合作,对邮寄问卷中的自由文本评论进行了定性内容分析。总回复率为 59.2%。在 933 位受访者中,有 1107 条评论。自由文本评论包括支持和反对 PAS 的规范性和事实性论据。分析结果分为两大类:(1) "无法安全实施临终关怀"(子类为 "临终关怀的标准难以实现 "和 "临终关怀使社会规范和价值观面临风险")和 (2) "临终关怀在医疗保健中的作用"(子类为 "临终关怀没有医疗需求"、"临终关怀不是医生的任务"、"与其他临终决定在伦理上没有区别 "和 "临终关怀符合患者的最佳利益")。受访者提出了学术界和公众辩论中众所周知的论点。医生反对临终关怀的评论则更多地带有情绪色彩,并使用了语病和滑坡论证等手段。
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来源期刊
CiteScore
2.70
自引率
6.20%
发文量
16
期刊介绍: Monash Bioethics Review provides comprehensive coverage of traditional topics and emerging issues in bioethics. The Journal is especially concerned with empirically-informed philosophical bioethical analysis with policy relevance. Monash Bioethics Review also regularly publishes empirical studies providing explicit ethical analysis and/or with significant ethical or policy implications. Produced by the Monash University Centre for Human Bioethics since 1981 (originally as Bioethics News), Monash Bioethics Review is the oldest peer reviewed bioethics journal based in Australia–and one of the oldest bioethics journals in the world. An international forum for empirically-informed philosophical bioethical analysis with policy relevance. Includes empirical studies providing explicit ethical analysis and/or with significant ethical or policy implications. One of the oldest bioethics journals, produced by a world-leading bioethics centre. Publishes papers up to 13,000 words in length. Unique New Feature: All Articles Open for Commentary
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