Togolese lay people's and health professionals’ views about the acceptability of physician-assisted suicide

Abstract

Aim:To study the views of lay people and health professionals in an African country, Togo, of the acceptability of physician-assisted-suicide (PAS). February-June 2012, 322 lay people and 198 health professionals (75 physicians, 60 nurses, and 63 health counselors) in Togo judged the acceptability of PAS in 36 concrete scenarios composed of all combinations of four factors: (a) the patient's age, (b) the level of incurability of the illness, (c) the type of suffering, and (d) the patient's request for PAS. In all scenarios, the patients were women who were receiving the best possible care. The ratings were subjected to cluster analysis and analyses of variance. Method: In Results:The majority of lay people (59%) were not systematically opposed to PAS, whereas the majority of health professionals (80%) working in the same area were opposed to it. The most important factors in increasing acceptability among people who were not systematically opposed were advanced age of the patient and untreatability of the illness. Additional acceptability was provided by the patient's request to have her life ended, although much so less than in studies in Western countries, and suffering characterized by complete dependence rather than by extreme physical pain. Conclusion:These empirical findings --the first ones gathered in the African continent--suggest that most Togolese lay people are not categorically for or against PAS, but judge its degree of acceptability as a function of concrete circumstances.

Cultural Differences in Perceived Appropriateness of Breaking Bad News to Patients: A Direct Comparison of Togo and France

“…These findings were consistent with previous empirical studies in sub-Saharan African countries that suggested that respect for individual autonomy in health care is not a strongly endorsed value among African people (Kpanake, Dassa, Sorum, & Mullet, 2014;Solum, Maluwa, & Severinsson, 2012; see also Kpanake, 2018). The salience of individual autonomy and self-determination in Western Europe cultural context may explain the French sensitivity to patients' autonomy in health communication.…”

Breaking Bad News to Togolese Patients

“…In contrast, such a position was held by less than 2% of the African participants. These findings are consistent with previous empirical studies in sub-Saharan African countries that suggested that respect for individual autonomy in health care is not a strongly endorsed value among African people (Kpanake, Dassa, Sorum, & Mullet, 2014;Solum, Maluwa, & Severinsson, 2012). Thus, while in the West any reluctance to tell bad news directly to patients is often blamed on physician paternalism (Beauchamp & Childress, 2008;Jennings, 2014), in Africa it is more a result of people's widely-shared cultural beliefs (Harris, Shao, & Sugarman, 2003;Solum, Maluwa, & Severinsson, 2012).…”

Colombian people's positions regarding physician-assisted suicide

“…Each person was tested individually according to the procedure used in previous studies. 8 The experimenter explained to the participants what was expected, that is, that for each scenario they were to indicate the degree of acceptability of a decision to resort to physician-assisted suicide. They made ratings at their own pace, and the experimenter made certain that the participants understood all relevant information before they made ratings.…”