Attitudes of Physicians towards Different Types of Euthanasia in Kuwait

Abstract

Objective: Although in recent years the world has witnessed great advances in the medical field, much ambiguity still surrounds the issue of euthanasia and physician-assisted suicide, with increasingly favorable attitudes among physicians around the world. In our study, we aimed to assess the attitudes of physicians in Kuwait towards different types of euthanasia and examine whether physicians’ frequent encounters with terminally ill patients were associated with their approval. Subjects and Methods: We conducted a cross- sectional study on 464 physicians employed in government hospitals (6 general and 3 specialty hospitals). A self-administered questionnaire adapted from previous studies was used. Results: Of the physicians in our study, 43.9% reported that the Ministry of Health should legalize euthanasia under certain restricted conditions. In addition, 29.1% of our population was willing to perform euthanasia. After controlling for several characteristics in logistic regression analysis, approval of passive euthanasia was significantly associated with the following 2 factors: frequent exposure to terminally ill patients (AOR = 2.45) and obtention of the basic medical degree from Asia (AOR = 4.36) or North America/Europe (AOR = 3.24) compared to Kuwait. Male gender was significantly associated with willingness to perform euthanasia. Religion was the major reason for opposing euthanasia. Conclusion: The attitudes of physicians towards euthanasia are diverse, and therefore the Ministry of Health should provide guidelines for physicians dealing with situations where patients or their families request euthanasia.

The Islamic perspective on physician-assisted suicide and euthanasia

“…12 PAS, on the other hand, is defined as the provision of prescription for lethal medication to a competent patient who is terminally ill upon his/her request to take on their own life. 14 Other terms used to describe PAS are 'medical aid/ assistance in dying', 'assisted dying', 'physician-assisted death' and 'suicidal euthanasia'. 16 Non-voluntary euthanasia refers to the termination of life without explicit request and is typically practiced on patients who lack decisional capacity.…”

Factors affecting the attitudes and opinions of ICU physicians regarding end-of-life decisions for their patients and themselves: A survey study from Turkey

“…It has been shown that country of origin, cultural background and religious background influence physicians' attitudes and practice of medicine, including EOL care, although only in relatively few studies [6,7]. Some previous studies have shown that Muslim physicians are more likely than non-Muslim physicians to object to the concepts of withdrawal from life support or artificial nutrition, physician-assisted suicide, and terminal sedation [6,[8][9][10][11].…”

Defining Euthanasia and the Need to be Circumspect in the Usage of the Term

“…While I laud Abohaimed et al [1] for taking on the important, challenging, and seldom discussed topic of euthanasia, I am also constrained to point out some deficiencies (i) in definition and typing, (ii) in consistency of “types” of euthanasia (4 in text and 3 in figure), and (iii) in bundling together “types” that has different ethical and legal implications. Admittedly, most of the definitions of euthanasia are descriptive, and there are multiple interpretations in the literature.…”

“…Passive and indirect “types” are not to be considered euthanasia, and my reasons are stated in comments that follow the authors statements. The authors state passive euthanasia is “withholding or withdrawing of life-sustaining treatment either at the request of the patient or when prolonging life is considered futile” [1]. Withholding or withdrawing of life-sustaining treatment at the request of a patient is not euthanasia as it is grounded on “patient autonomy,” one of the basic principles of medical ethics [5].…”

“…The term indirect euthanasia is used by the authors for “the prescription of pain killers that may be fatal in an attempt to relieve suffering” [1]. Relieving the suffering of a patient is not only the primary mission of palliative care but it is also a core obligation of any physician.…”