Table 4 Themes illustrating reasons given for answers ‘yes’, ‘no’ or ‘unsure’ to explain responses to questions 1 (section 2)
From: New Zealand medical students’ views of euthanasia/assisted dying across different year levels
Years 2 & 3 | |
|---|---|
Themes for supporting a law change | Example |
Relieving suffering | “To stop patient suffering. If a patient is already going to die in 10 days and they are suffering miserably, I think euthanasia has a place by reducing the length of suffering. But I think this is one of the only situations in which it should be used.” |
Autonomy | “At the end of the day people deemed “competent” should have no reason to not be able to make a choice about ending their life in a comfortable way if that is what they really desire.” |
Enabling a dignified death | “Think people should be able to die with dignity if they want” |
Financial reasons | “Thinking about hospital resources it would also save an incredible about of money and free up beds (for people who have a chance to improve their quality of life).” |
Themes for opposing a law change | Example |
Potential for misuse | “I do not support a law change due to lack of trust in the system. I see far too many opportunities for health care practitioners (not just doctors) to become ‘trigger happy’ or forceful about euthanasia. I also envision situations wherein patients feel pressured to accept this as an option. There is also quite a lot of room in the system for error and/or abuse of elders and those with disabilities.” |
Sanctity of life | “… and I think euthanasia could have a strong follow on effect in the community in regards to how illness and life quality is viewed” |
Slippery slope | “Concern over how this could be used and could progress to include mental illness and childhood illness” |
Not the role of doctor | “Not the place of the medical profession to carry out this role; does not align with mission; could jeopardise public trust in the profession, with flow-on effects for public health (e.g. not following health advice, avoiding GP and hospitals)” |
Themes for being unsure about a law change | Example |
Potential for misuse | “It is very complex. On one hand I don’t have a problem with easing the end for people with progressive conditions. On the other hand I have concerns about how the system will work and be used. My fear is that those with disabilities might be at risk. Or those with mental illness. Or those that see themselves as a burden, rather than actually wanting to end their own suffering, using it as a tool to “end” the suffering of those around them.” |
Not the role of doctor | “Furthermore, this changes the perception of doctors. A profession that willingly participates in euthanasia is not one I signed up for.” |
General uncertainty | “However, I have lived a fortunate life and have not know anyone to experience a drawn-out, painful death, so I can’t pretend that I know what’s best for people in that position - hence on the fence.” |
Relieving suffering | “Because it is a complex issue and people’s lives and connections to others are also complex as could be the influences on the person thought to be voluntarily and competently requesting to do this. On one hand this may well be the compassionate and empathetic thing to provide for a person who is in pain, suffering and terminally ill.” |
Years 4 & 5 | |
Themes for supporting a law change | Example |
Relieving suffering | “In some circumstances, the end of life can be very prolonged and difficult and this can worsen suffering for the dying individual and their family.” |
Autonomy | “It’s rooted in a fundamental respect of individual’s right to choose for themselves.” |
Enabling a dignified death | “It is the single best way to allow patients with debilitating terminal diseases to choose to have a good death.” |
Relief for family | “In some circumstances, the end of life can be very prolonged and difficult and this can worsen suffering for the dying individual and their family.” |
Themes for opposing a law change | Example |
Potential for misuse | “Having seen abuses of patients within the healthcare system (outside of medical school) and aware as I am of our imperfect and socially unequal society, I am quite nervous about vulnerable people being under pressure either within the healthcare system or by family or personal circumstances to choose assisted dying when it would not have been their choice otherwise.” |
Not the role of doctor | “It places doctors in a position where they take life.” |
Palliative care as an alternative to EAD | “A comprehensive study regarding the symptoms a person at EOL experience showed that the process of dying itself can be very peaceful with appropriate palliative care input, e.g. pain is less of a concern than the general population would think. We have a robust palliative care system in NZ and I believe we would be demeaning its importance if we legalised euthanasia …” “… Rather than focusing on euthanasia, I think it would be more beneficial in the long-term to focus on a robust palliative care system …” |
Personal values | “I personally believe that life is sacred and that no person should be legally allowed to end another person’s life, even at the other person’s request” |
Themes for being unsure about a law change | Example |
Undermines palliative care | “I would also want to ensure palliative care wouldn’t be neglected because euthanasia was brought in.” |
Not the role of doctor | “Doctors could administer the euthanasia, but I don’t think they should have a role in assessing or deciding if someone should receive euthanasia.” |
Potential for misuse | “I predict that assessing competence and the whole process in general may be fraught with danger and difficulties. The person could be persuaded/pressured by family and friends or they may feel pressure to end their life independent of anything the family have actually done.” |
Autonomy | “I believe in autonomy - and have met many patients who are terminal and say they want to die. But I think legislating is fraught with difficulty.” |