New Zealand medical students’ views of euthanasia/assisted dying across different year levels

Abstract

Background Previous studies report a majority of the general public support euthanasia/assisted dying (EAD), while a majority of doctors are opposed. In considering policy decisions about EAD, some may discount the views of doctors because they take them to be based on personal values or tradition, rather than reasons that the general public might share. One way to explore this notion is to examine whether medical students’ views change during their medical education. The objective of this study was to learn how New Zealand medical students view EAD and whether students at different year levels have different views. Methods An on-line survey of undergraduate medical students was conducted asking whether they supported a law change to allow EAD. Quantitative data was analysed using unadjusted and multiple logistic regression. Thematic analysis was conducted with the qualitative data. Results A total of 326 students replied to the survey. The overall response rate was 28%. 65% of 2nd year students were supportive of EAD, compared to 39% in 5th year. The odds of 5th year students supporting a law change compared to 2nd year was 0.30 (95% CI: 0.15–0.60). The predominant themes found in the qualitative results indicate that medical students support or oppose EAD for reasons similar to those found in the wider debate, and that their views are influenced by a range of factors. However, several at all year levels cited an aspect of medical school as having influenced their views. This was mentioned by participants who were supportive of, opposed to, or unsure about EAD, but it was the type of influence most often mentioned by those who were opposed. Conclusions The quantitative findings show students at the end of 5th year were less likely to support EAD than students at the end of 2nd year. We suggest that this difference is most likely due to their time in medical education. This suggests that the lower support found among doctors is in part related to medical education and medical work rather than age, personality, or social context. The qualitative findings indicate that this is not related to a particular educational experience at Otago Medical School but a range.

Euthanasia in opinions of students of medicine

“…Studies of medical students from New Zealand carried out in 2020, i.e. before the legalization of euthanasia in that country which took place in November 2021, showed the existence of a relationship between support for EAD and the stage of education [17]. Acceptance of EAD was supported by 65% of third-year students and only 39% of fifth-year…”

“…In 2021, New Zealand joined the countries where euthanasia is allowed. Legislation is currently being prepared to allow euthanasia in Portugal [17]. Suicides assisted by a physician, excluding euthanasia, are legal in Switzerland, and in five states in the USA: Oregon, Washington, Montana, Vermont and California [18,19].…”

Personality traits and attitude towards euthanasia among medical students in Serbia

“…17 However, our findings contrast previous research where students in the second year felt a stronger positive attitude towards euthanasia compared to students in the fifth study year. 12 Specifically, Nie et al 12 from New Zealand found that medical students in the fifth year were approximately 70% less likely to support legalization of euthanasia compared to their younger colleagues. Furthermore, a study of Głębocka 27 that compared the attitudes of nurses and laypeople found that exposure to death and dying did not increase support for euthanasia, thus the results concerning support for euthanasia.…”

“…[7][8][9][10] In addition, general practitioners were less supportive of euthanasia compared to senior medical students, 11 while medical students in fifth study year were less inclined towards euthanasia compared to students in second study year. 12 However, some evidence suggests that having more clinical experience with mental health counselling helps foster a positive attitude towards euthanasia. 9,13 Finally, traits such as authoritarianism 7 and honestyhumility, agreeableness and conscientiousness have been associated with a negative attitude towards euthanasia, 14 while openness to experience was seen as a personality trait that favours positive attitude towards euthanasia in different cultural settings.…”

The Ethics of Dying: Deciphering Pandemic-Resultant Pressures That Influence Elderly Patients’ Medical Assistance in Dying (MAiD) Decisions

“…For example, South Africa's position on the matter is unclear; the practice is illegal but, in cases where MAiD was performed, there were no legal consequences [5]. Meanwhile, in New Zealand, MAiD is set to become legal in late 2021 with mixed opinions [6]. In Canada, the procedure is available to adults only, near death, suffering from a non-mental illness, with no recovery possible.…”