Abstract
In November 1994, Oregon became the first US state to legalize physician-assisted suicide (PAS) as an option for end-of-life care. This study compares the attitudes and experiences of medical students in Oregon regarding PAS to those of fourth-year medical students in the United States outside Oregon. A survey of all students at the Oregon Health Sciences University and fourth-year medical students at 3 non-Oregonian US medical schools. Oregon medical students returned 227 questionnaires (58%), and 113 were returned from control schools (33%). A similar percentage of both study groups favored the legalization of PAS (64% vs 66%; P = .74). If the practice were legal, 55% of the total surveyed reported they "might be willing to write a lethal prescription," (50% Oregon students vs 60% control; P = .13 and 44% fourth-year Oregon students vs 60% control; P = .04). Among fourth-year students, 20% reported a request by a patient to the student or a preceptor for a lethal prescription in the past year (26% vs 16%; P = .09). This study demonstrates support for and willingness by many medical students to participate in PAS. Some medical students reported observation of PAS during their training experience. Fourth-year Oregon students reported significantly less willingness than other students to provide a patient with a lethal prescription, perhaps indicating hesitancy to include PAS in clinical practice.
Highlights
MSJAMA is prepared by the MSJAMA editors and JAMA staff and is published monthly from September through May
Among fourth-year students, 20% reported a request by a patient to the student or a preceptor for a lethal prescription in the past year (26% vs 16%; P = .09)
This study demonstrates support for and willingness by many medical students to participate in physician-assisted suicide (PAS)
Summary
All submissions must be the original unpublished work of the author. Address submissions and inquiries to: MSJAMA, Jonathan H. The disciplines of economics and bioethics have each outlined strategies to mitigate this conflict. Bioethics often addresses the variance among competing values without accounting for resource scarcity.[1] When the overall priority is to decrease monetary costs, selecting the most desirable way to allocate resources depends on which values are assumed to be paramount.[2] If we are to develop morally acceptable principles for allocating scarce resources, the two approaches must reach a concordance. Decisions regarding the delivery of health care at the end of life underscore the inherent conflict between economics and bioethics. Many argue that because 10% to 12% of all health care expenditures and 27%
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