If it boils down to a choice between letting a patient carry on suffering insurmountable and unmanageable pain, or helping end their misery, a significant number of the country’s future doctors are in favour of euthanasia.
This is according to a new study published in the latest SA Medical Journal, which surveyed close to 300 third- to fifth-year medical students at the University of Stellenbosch. It revealed that at least 52% of them were in favour of euthanasia and physician-assisted suicide being legalised in the country.
And 47.7% of them believed that doctors should be allowed to help patients hasten their death upon a patient’s competent request.
Euthanasia is defined as “a doctor intentionally killing a person by the administration of drugs at that person’s voluntary and competent request”; physician-assisted suicide is “a doctor intentionally helping a person commit suicide by providing drugs for self-administration at the person’s voluntary and competent request”.
The study, titled Medical Students’ Perspectives on Euthanasia and Physician-assisted Suicide and their Views on Legalising these Practices in SA, gives the glaringly missing viewpoint of medical professionals in the morally divided debate of the taboo life-ending interventions in the country.
“So far, the courts have taken centre stage in the euthanasia debate, but with the recent developments, particularly in the Stransham-Ford vs the minister of justice and correctional services case, the need to engage medical professionals has become urgent,” the study researchers contend.
Lead researcher and fifth-year medical student Ryan Jacobs told City Press this week: “The most surprising result from this study was not the number of participants who were in favour of legalising these practices, but rather which patient ‘type’ the students would most likely assist in their request for hastening death.”
He said they purposefully made the distinction between two similarly sketched patient profiles (both had terminal metastatic cancer with intractable suffering), but with one being described as “unlikely to die soon”.
“The difference in response from students who were willing to assist the latter patient in hastening his or her death was merely 12.6% – from 41.9% in favour of assisting the patient with the same co-morbidities, but described as ‘likely to die from the condition’,” Jacobs said.
Jacobs said the students proved to be very “strict” in who they would help to die.
The study made reference to cases brought before the country’s judicial system, such as the 1975 “mercy killing”, in which Dr Alby Hartman was convicted of injecting his terminally ill father with an overdose of pentothal, but, in a landmark ruling, was sentenced to the “rising of the court”, meaning he was a free man as soon as the court adjourned.
The most recent physician-assisted suicide application at the Pretoria High Court involved terminally ill advocate Robin Stransham-Ford in 2015, whose application was granted, but he died just hours before the ruling was passed.
“In light of the renewed interest in the debate and the changing legal landscape, it was considered important to ascertain the views and opinions of these future doctors with regard to euthanasia and physician-assisted suicide, as it is believed that their views might determine their behaviour towards patients and peers,” the study noted.
In the first set of questions the students answered – which explored student attitudes to life-ending requests and the legalisation of the interventions in South Africa – 57% of them believed that the patient should have the final decision in choosing to end his or her life.
Despite 52.7% of participants being in favour of legalising the practice of euthanasia and physician-assisted suicide in South Africa, 63.5% said they would still attempt to persuade a patient to choose a palliative treatment method instead of life-ending intervention.
The main arguments in support of euthanasia and physician-assisted suicide given by students were respecting patient autonomy and providing a relief to suffering.
But those against euthanasia and physician-assisted suicide argued that the practices went against the doctor’s oath to preserve life, that it was morally wrong and against their world and religious beliefs, and that the practices presented a “slippery slope” towards active involuntary euthanasia.
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