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Survey on Euthanasia and Assisted SuicideSurvey on Euthanasia and Assisted Suicide

Prepared For:Prepared For:

Presentation of Results Presentation of Results Results from 986 interviews Results from 986 interviews

2626thth March – 9 March – 9thth April 2003 April 2003

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• Following the current debate in the media and the Houses of Parliament regarding the issue of assisted suicide and euthanasia, The Opinion Research Business was asked by the Right to Life organisation to conduct a quantitative survey amongst a nationally representative sample of medical professionals in the UK. The aim of this survey was to find out the views of medical professionals on this topical issue.

• Due to the highly sensitive nature of the subject matter, an internet survey was perceived as the most appropriate method of achieving the required interviews. As it is a self-completion method, it is totally confidential.

• The survey was administered by Doctors.Net.UK, the foremost medical internet company in the UK.

• The survey was completed by 986 medical practitioners over a two week period, from March 26th to April 9th 2003.

BackgroundBackground

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• A total of 9,000 doctors were approached over this period.

• To ensure the representative nature of the survey, only doctors who had been initially selected at random by Doctors.Net.Uk could participate. We were assured that this 11% response rate was typical of this type of internet survey.

• The sample was chosen to reflect the wide range of medical professionals, distributed as follows:

Actual

% Number

66 646 General Practice

13 124 Psychiatry

4 44 Geriatric medicine

3 28 Oncology

2 19 Internal (general) medicine

2 17 Palliative medicine

10 108 Other

BackgroundBackground

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Majority Opposed to Euthanasia and Assisted SuicideMajority Opposed to Euthanasia and Assisted Suicide

Q10. As a doctor, are you in favour of either of the following?

25% 60% 13% 2%

22% 61% 14% 3%

Yes No Don't know No answer

Euthanasia

Assisted Suicide

• The survey reveals that the majority of doctors are not in favour of either euthanasia (61%) or assisted suicide (60%).

• Only 22% of medical professionals are in favour of euthanasia and only 25% are in favour of assisted suicide.

• A significant number (13/14%) were undecided, mainly because they were not directly involved in the decision-making process.

Table 1

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Majority Would Not Perform either Euthanasia or Majority Would Not Perform either Euthanasia or Assisted SuicideAssisted Suicide

Q11. If these actions were made legal, would you be prepared to perform any of the following?

26% 74% 0%

23% 76% 1%

Yes No No answer

Euthanasia

Assisted Suicide

• Even fewer doctors would be prepared in practice to perform either euthanasia or assisted suicide if they were made legal (76% and. 74% respectively).

• Only about a quarter of doctors would be prepared to perform euthanasia (23%) or assisted suicide (26%) if these actions were made legal.

• The groups which are least likely to perform euthanasia are those in palliative and geriatric medicine and oncologists.

• No one in palliative care would be prepared to perform assisted suicide, nor would the vast majority of those in either internal general medicine or oncology.

Table 2

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Factors Affecting Doctors’ Judgement: Factors Affecting Doctors’ Judgement: Pressure from RelativesPressure from Relatives

Q12. If these actions were made legal, would you be confident that you would be able to exercise your judgement free from: a) Pressure from relatives

30%

28%

24%

26%

26%

47%

44%

46%

29%

All respondents

Would perform Assisted Suicide

Would perform Euthanasia

Yes

No

Don’t know

• Only three in ten (29%) doctors said that they were confident that they would be able to exercise their judgement free from pressure from relatives.

• However, this figure was significantly higher amongst those who would be prepared to perform euthanasia or assisted suicide (46% and 44% respectively). Those in geriatric medicine were the most confident, whereas those in palliative medicine were the least.

• There were high numbers of “don’t know” responses across all sub-groups, indicating widespread uncertainty or lack of information.

Table 3

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Factors Affecting Doctors’ Judgement: Factors Affecting Doctors’ Judgement: Pressure from BeneficiariesPressure from Beneficiaries

Q12. If these actions were made legal, would you be confident that you would be able to exercise your judgement free from: b) Pressure from beneficiaries

10%

11%

12%

9%

10%

29%

81%

79%

58%

All respondents



Yes

No

Don’t know

• The majority (58%) of doctors said that they were confident that they would be able to exercise their judgement free from pressure from beneficiaries (compared to just 29% regarding pressure from relatives).

• Once again, this figure was significantly higher amongst those who would be prepared to perform euthanasia or assisted suicide (81% and 79% respectively). A majority of those in geriatric medicine were confident, compared to a minority in palliative medicine.

Table 4

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Factors Affecting Doctors’ Judgement: Factors Affecting Doctors’ Judgement: Pressure from Medical and Nursing ColleaguesPressure from Medical and Nursing Colleagues

Q12. If these actions were made legal, would you be confident that you would be able to exercise your judgement free from: c) Pressure from medical and nursing colleagues

35%

33%

28%

25%

26%

43%

40%

41%

28%

All respondents



Yes

No

Don’t know

• It would seem that doctors were most concerned about possible pressure from medical and nursing colleagues – only 28% say that they were confident that they would be able to exercise their judgement free from pressure from their colleagues.

• Once again, for those prepared perform euthanasia or assisted suicide, the survey showed that they were significantly more confident than those who were not. Those in geriatric medicine were the most confident of all, and those in palliative medicine the least.

• The high numbers of “don’t know” responses across all sub-groups indicates widespread uncertainty or a lack of guidance or direction; this includes more than a third (35%) of those who would be prepared to perform euthanasia.

Table 5

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Factors Affecting Doctors’ Judgement: Factors Affecting Doctors’ Judgement: Consideration of NHS ResourcesConsideration of NHS Resources

Q12. If these actions were made legal, would you be confident that you would be able to exercise your judgement free from: d) Consideration of NHS resources

15%

13%

15%

12%

15%

28%

72%

70%

57%

All respondents



Yes

No

Don’t know

• The majority (57%) of doctors said that they were confident that they would be able to exercise their judgement free from consideration of NHS resources.

• Once again, those who would be prepared to perform euthanasia or assisted suicide were much more confident than the sample as a whole (72% and 70% respectively).

• However, more than one in four (28%) doctors were not confident about this, especially those in palliative medicine.

Table 6

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Majority of Doctors Do Not Think the BMA Should Majority of Doctors Do Not Think the BMA Should Change its PolicyChange its Policy

Q13. The BMA is currently opposed to the legislation of euthanasia/assisted suicide. Do you think it should change its policy?

15%

17%

13%

11%

10%

59%

75%

73%

28%

All respondents



Yes

No

Don’t know

• The majority (59%) of doctors do not think the BMA should change its policy, indicating that they are also opposed to the legislation of euthanasia/assisted suicide. This includes all doctors who work in palliative medicine.

• Unsurprisingly, three quarters of those who would be prepared to perform euthanasia or assisted suicide think that the BMA should change its policy (75% and 73% respectively).

Table 7

11

Agree

Disagree

Don’t know7%

6%

7%

79%

81%

37%

14%

13%

56%

All respondents



Views on Whether Safe Bounds on Euthanasia Views on Whether Safe Bounds on Euthanasia Can Be SetCan Be Set

Q1. In 1994, the House of Lord's Select Committee on Medical Ethics said that it would be impossible to set safe bounds on euthanasia. Do you agree or disagree with this statement?

• The majority (56%) of doctors in the UK agree with the statement from the House of Lord’s Select Committee on Medical Ethics that it would be impossible to set safe bounds on euthanasia. This rises to almost all those involved in palliative medicine and 87% of those who said that were not in favour of either euthanasia or assisted suicide.

• However, amongst those who are prepared to carry out either euthanasia or assisted suicide, four in five doctors disagree with the statement by the House of Lords.

Table 8

12

Very confident

Quite confident

Not very confident

Not confident

Confidence To Detect Whether a Request for Assisted Confidence To Detect Whether a Request for Assisted Suicide Was Part of a Depressive IllnessSuicide Was Part of a Depressive Illness

Q7. How confident are you that it would be possible to detect whether a request for assisted suicide was part of a depressive illness?

2%2%

7%

20%19%

30%

59%

61%

53%

19%19%

10%

All respondents



• The majority (63%) of doctors are confident that they would be able to detect whether a request for assisted suicide was part of a depressive illness.

• Only one in ten doctors claim to be very confident; those who would be prepared to carry out either euthanasia or assisted suicide were much more confident.

• The figures for those who would be prepared to carry out either euthanasia or assisted suicide are very similar – both groups have higher levels of confidence than the sample as a whole (79% and 80% respectively).

Table 9

13

Yes

No

Don’t know

12%

11%

12%

36%

37%

22%

52%

52%

66%

All respondents



Implications of Increasing Resources for the Implications of Increasing Resources for the Hospice MovementHospice Movement

Q8. Do you think that the pressure for euthanasia/assisted suicide would be lessened if there were more resources for the hospice movement?

• Two in three doctors think that the pressure for euthanasia or assisted suicide would be lessened if there were more resources for the hospice movement. This figure increases amongst those in internal (general) medicine and palliative medicine.

• However, only half (52%) those who are prepared to carry out either euthanasia or assisted suicide think that pressure would be lessened in this instance.

• More than one in ten (12%) doctors say that they do not know.

• Doctors in palliative care were more supportive of the implications of greater resources for the hospice movement.

Table 10

14

Yes

No

Don’t know

12%

13%

15%

44%

48%

30%

15%

39%

55%

All respondents



Implications of Increasing Resources for Geriatric CareImplications of Increasing Resources for Geriatric Care

Q9. Do you think that the pressure for euthanasia/assisted suicide would be lessened if there were more resources for geriatric care?

• The majority (55%) of doctors think that the pressure for euthanasia or assisted suicide would be lessened if there were more resources for geriatric care. This figure increases amongst those in palliative medicine.

• Interestingly, there is a distinct difference in the opinions of those who would be prepared to carry out euthanasia and those who would perform assisted suicide – over a third (39%) of those who would perform euthanasia think that the pressure would be lessened in these circumstances, compared to just 15% of those who would carry out assisted suicide.

• Again, a significant number of doctors (15%) say that they do not know. This is even higher amongst oncologists.

Table 11

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General Practice

Psychiatry

Geriatric medicine

Oncology

Palliative medicine

Internal (general) medicine

Other

Medical ClassificationMedical Classification

10%

2%

2%

3%

4%

13%

66%

All respondents

• Two thirds (66%) of those interviewed work in General Practice.

• A fairly high proportion (13%) of the sample work in psychiatry, which increases slightly to 15% amongst those who would perform either euthanasia or assisted suicide.

• “Other” includes Nephrology (1%), Neurology (1%), Haematology (1%), and Paediatrics (1%).

Table 12

16

None

Less than 5

Between 5 and 10

Between 10 and 100

Don’t know / not applicable

Other

Number of Patients who have Requested Euthanasia Number of Patients who have Requested Euthanasia in last 3 yearsin last 3 years

Q16. How many patients would you estimate have requested euthanasia over the last three years?

1%

2%

2%

11%

37%

48%• The survey reveals that for nearly half (48%) the medical professionals, none of their patients have requested euthanasia in the last 3 years.

• “Other” includes the following comments:

- “Persistent, competent requests – 10; cries for help that have been resolved with good symptom control, listening and information - probably about 36”

- “Very few make a genuine request for euthanasia – they almost invariably want relief from distress”

- “Very few serious requests, older people often say they wish they were dead, not really the same thing”

Table 13

17

None

Less than 5

Between 5 and 10

Between 10 and 100


Other

Number of Relatives who have Requested Euthanasia for Number of Relatives who have Requested Euthanasia for them in last 3 yearsthem in last 3 years

Q17. How many patients would you estimate have requested euthanasia over the last three years?

1%

3%

1%

5%

22%

68%• Two thirds (68%) of doctors said that none of their patients’ relatives had requested euthanasia for them in the last 3 years.


- “Can only remember a couple when the patient didn't want it themselves and they were relatives of patients with severe dementia who (according to relative at any rate) had previously expressed but never written down their wishes to this effect”

- “Far more than patients!”

- “They wish something quicker could happen”

- “I have had no serious discussions”

Table 14

18

None

Less than 5

Between 5 and 10

Between 10 and 100


Other

Number of Death Certificates Signed Number of Death Certificates Signed over the last 12 monthsover the last 12 months

Q18. How many death certificates have you signed over the last 12 months?

• Although 50% of medical professionals had signed fewer than 5 death certificates in the last 12 months, nearly one in five (18%) had signed between 10 and 100.


- “Hundreds - second cremation signatory”

- “Not relevant - signed by Junior Hospital Staff”

- “None (HOs sign them, I've had plenty of deaths!)”

Table 15

1%

2%

18%

30%

28%

22%

19

30 years or younger

31 - 40

41 - 50

51 - 60

61 years and above

Age and Gender of RespondentsAge and Gender of Respondents

2%

12%

30%

40%

16%

Table 16 - Age

36%

64%

Male Female

Table 17 - Gender

• A wide range of ages completed the survey; however, only a small minority are at retirement age.

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