The University Record, May 22, 1995
By Joan Siefert Rose
Medical Center Public Relations
As the national debate continues on the legal and ethical issues surrounding the assisted suicide of patients by Dr. Jack Kevorkian, a new survey of Michigan oncologists finds that nearly 21 percent would favor legislation allowing physician-assisted death, and almost as many acknowledge having participated in such an activity. The findings are published in the May issue of the Journal of Clinical Oncology.
David J. Doukas, assistant professor of family practice, notes, however, that responses to the survey are strongly polarized, with philosophical attitudes and religious beliefs strongly influencing individual oncologists' views on active euthanasia and their willingness to provide the means for a patient's suicide.
"We were not surprised to find that the majority of doctors specializing in the treatment of cancer patients would have reservations about acting on requests to hasten a person's death, even if that option were made legal," he says. "What is noteworthy is the extent to which a physician's personal philosophy affects his response to those requests. This has significant implications for public policy."
Doukas questioned cancer specialists because they treat a relatively high percentage of terminally ill patients and therefore are more likely to directly confront the issue of assisted suicide.
The survey, measuring both attitudes and experiences of oncologists toward physician-assisted death, drew responses from 154 Michigan cancer specialists. Of this group, 18 percent reported participating in assisted suicide and 4 percent in active euthanasia. By contrast, more than 80 percent of the respondents acknowledged ending therapy at a patient's request, a practice that has gained wide medical and legal acceptance.
Doukas found that oncologists in academic medical centers were five times more likely than cancer specialists in community hospitals to support physician-assisted death. Fourteen percent of the university-based oncologists also said they had given medication with the intent to cause death, compared to one percent of community-based oncologists. Possible explanations for the disparity are that doctors in favor of physician-assisted death may be drawn to academic settings, or that doctors in academic medical centers may see themselves as somehow more removed from their patients than doctors in community hospitals, Doukas says.
In addition, religious beliefs seem to play a role. Nearly one-half of the doctors indicating no religious affiliation said they would be willing to provide the means by which a patient could end his life. By comparison, only 25 percent of Jewish oncologists, 10 percent of Catholic physicians and 9 percent of Protestant doctors agreed with that statement. Doukas says the sample groups were small, and the influence of religion on physician attitudes should be explored further.
The U-M researcher concludes that even if laws in Michigan are changed to allow some forms of physician-assisted suicide, patients may have trouble finding an oncologist willing to carry out their wishes.