Medical students: More study more opposition to euthanasia

Medical students become more opposed to euthanasia during their training as they progress through medical school, a new study says.

In their second year, almost 65 percent of medical students at Otago University supported euthanasia or assisted dying.

Support for the practice reduced during each year of training: by their third year it fell to 62.6 percent of students, 51.5 percent in their fourth year and 39.1 per cent in their fifth year.

“We suggest that this difference is most likely due to their time in medical education,” the researchers say.

The structure of medical school was likely a factor, one of the research group, Simon Walker, says.

First and second year students see few patients and their views mirrored the results of the End of Life Choice referendum held last November: 65 per cent in favour of legalisation, 34 percent opposed.

By fifth year, however, the students see many patients and are “confronted… by the complexities” that can come up in end-of-life situations, Walker says.

Otago med students are taught palliative medicine and end-of-life care throughout most of their education.

They are also taught bioethics, although generally focusing on identifying issues and enabling students to think for themselves, Walker says.

Walker is a bioethicist and teaches some of these classes.

Professors, doctors and nurses with strong views on euthanasia probably make impressions on the students as well, he says.

In addition, he thinks the students are “working out how to survive in the profession and that requires a kind of conformity,” he adds.

Ending a life was “contrary” to what med students were trying to become, Walker says.

“Their whole orientation is to try and make things better, and ending a person’s life doesn’t feel that way.”

Surveys of working doctors have showed they oppose, by wide margins, what the New Zealand Medical Association calls “doctor-assisted suicide.”

A 2018 survey of 298 working doctors, for example, found 34.5 percent would be willing to prescribe lethal medication. This percentage is similar to the fifth-year Otago student survey.

Research team member Luke Nie​ initiated the student survey in 2018, when he was a second-year medical student at Otago.

Now in his fifth year of training, he will survey his peers again this year to track changes.

He also plans to repeat deeper interviews with a small group.

Walker hopes the new survey will provide greater insights into how medical students are thinking through assisted death and the major factors affecting their positions.

He expects to see them raise ethical concerns and an awareness that assisting death was a “hard thing to do and a hard thing to be involved with.”

The End of Life Choice Act comes into force in November, meaning these students will soon graduate into a New Zealand where assisted death is legal and sought.

A total of 326 of the 1152 Otago students answered the survey, or 28 percent.

The study was published in the peer-reviewed, open access journal, BMC Medical Education.


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