Doctors' and nurses' attitudes towards and experiences of voluntary euthanasia: survey of members of the Japanese Association of Palliative Medicine

Atsushi Asai, Motoki Ohnishi, Shizuko K Nagata, Noritoshi Tanida and Yasuji Yamazaki

Kyoto University Graduate School of medicine, Japan, Kansai International Airport, Kyoto University Graduate School of Medicine, Hyogo College of Medicine and Kobe University, respectively

Objective—To demonstrate Japanese doctors' and nurses' attitudes towards and practices of voluntary euthanasia (VE) and to compare their attitudes and practices in this regard.

Design—Postal survey, conducted between October and December 1999, using a self-administered questionnaire.

Participants—All doctor members and nurse members of the Japanese Association of Palliative Medicine.

Main outcome measure—Doctors' and nurses' attitude towards and practices of VE.

Results—We received 366 completed questionnaires from 642 doctors surveyed (response rate, 58%) and 145 from 217 nurses surveyed (68%). A total of 54% (95% confidence interval (CI): 49-59) of the responding doctors and 53% (CI: 45-61) of the responding nurses had been asked by patients to hasten death, of whom 5% (CI: 2-8) of the former and none of the latter had taken active steps to bring about death. Although 88% (CI: 83-92) of the doctors and 85% (CI: 77-93) of the nurses answered that a patient's request to hasten death can sometimes be rational, only 33% (CI: 28-38) and 23% (CI: 16-30) respectively regarded VE as ethically right and 22% (CI: 18-36) and 15% (CI: 8-20) respectively would practise VE if it were legal. Logistic regression model analysis showed that the respondents' profession was not a statistically independent factor predicting his or her response to any question regarding attitudes towards VE.

Conclusions—A minority of responding doctors and nurses thought VE was ethically or legally acceptable. There seems no significant difference in attitudes towards VE between the doctors and nurses. However, only doctors had practised VE.

Key Words: Euthanasia • Japan • doctors • nurses • palliative care

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