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Attitudes of Hungarian students and nurses to physician assisted suicide
  1. S Fekete,
  2. P Osvath,
  3. A Jegesy
  1. Department of Psychiatry, University of Pecs, Pecs, Hungary
  1. Correspondence to:
 S Fekete, Department of Psychiatry, University of Pecs, 7623 Pecs, Ret u 2 Hungary;
 sfekete{at}neuro.pote.hu

Abstract

In Hungary, which has one of the highest rates of suicide in the world, physician assisted suicide (PAS) and euthanasia are punishable criminal acts. Attitudes towards self destruction and assisted suicide are, however, very controversial. We investigated the attitudes of medical students, nurses and social science students in Hungary towards PAS, using a twelve item scale: the total number of participants was 242. Our results indicate a particular and controversial relationship between attitudes towards assisted suicide in Hungary and experience with terminally ill people. The social science students, who had the fewest personal experiences with terminally ill patients, are characterised by the most permissive attitudes towards assisted suicide. Nurses, who had everyday contact and experience with these patients, were the most conservative, being least supportive of assisted suicide. The attitudes of medical students, the would be physicians, are somewhere between those of nurses and social science students.

  • Physician assisted suicide
  • attitudes of medical students and nurses

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The legal situation of assisted suicide and the attitudes towards it differ throughout the world.1 In Hungary, which has one of the highest rates of suicide in the world, physician assisted suicide and euthanasia are illegal, punishable criminal acts. The right to refuse a medical treatment has been permitted for three years in terminally ill cases. Attitudes towards self destruction and assisted suicide are, however, very controversial. We investigated the attitudes of medical students, that is, the medical professionals of the future, nurses, that is health care professionals now, and social science students, that is the social work professionals of the future, towards physician assisted suicide, using a twelve item scale. The number of participants was (n=242): male=67, female=175; mean age: 26 ys, SD 7.3; medical students (n=86), social science students (n=71) and nurses working with seriously ill patients (n=85). The scale was constructed and validated by Domino2 and was translated (with back-translation method) into Hungarian. The items were presented as an opinion scale with Likert-like response options. For the Hungarian samples the scale showed appropriate internal consistency (with Cronbach alfa indices in the low 0.80s), and temporal stability (test-retest reliability was 0.85)

Responses to 12 questions related to physician assisted suicide were compared. The results indicate that the majority of students sampled favour assisted suicide (60%), particularly the social science students (76%). A substantial majority disagree with the statement that a person does not have the right to end his or her life (80%). All three groups favoured laws to make physician assisted suicide legal (56–65%). Social science students would consider physician assisted suicide more frequently for elderly and ill persons than both of the other groups (66%, p<0.05). Medical students were quite uncertain and ambivalent. They had doubts about the legalisation of assisted suicide and euthanasia (44%), although they generally supported a person having a right to die (78%). They seemed to be more liberal in their attitudes to theoretical issues but more conservative in relation to practical ones. The nurse group were least supportive of assisted suicide and euthanasia (21%) and less inclined to support it for the terminally ill elderly (47%). An analysis of test scores (Kruskal-Wallis, Mann-Whitney scales) yielded a significant difference between the student and nurse groups in the majority of the items. There were some gender and age differences, with male and younger respondents showing more favourable attitudes towards assisted suicide.

Our results indicate a particular and controversial relationship between attitudes towards assisted suicide in Hungary and experience with terminally ill people. The social science students, who had the fewest personal experiences with terminally ill patients, are—theoretically—the most liberal group, characterised by the most permissive attitudes towards assisted suicide. Nurses, who had everyday contact and experience with these patients, were the most conservative, being least supportive of assisted suicide. The attitudes of medical students, the would be physicians, are somewhere between those of nurses and social science students.

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