Physician-assisted death doesn’t lesson patient trust
Only 20% would trust physician less
There is little evidence to support the argument that legalizing physician-assisted death would reduce patients’ trust in their doctors, according to researchers at Wake Forest (NC) University Baptist Medical Center.
"Overall, three times as many people disagree as agree that legalizing physician-assisted death would cause them to trust their personal doctors less," according to Mark A. Hall, JD, professor of public health sciences at Wake Forest Baptist and Fred D. and Elizabeth L. Turnage Professor of Law at Wake Forest University.
Hall and colleagues designed a random telephone survey of 1,117 adults in the United States to measure attitudes about physician aid in dying. The results were reported in the December 2005 issue of the Journal of Medical Ethics.
Survey participants were asked to use a five-point scale to state their agreement or disagreement with the following statement: "Assume for the purpose of this question that euthanasia were legal. If doctors were allowed to help patients die, you would trust your doctor less."
The question did not distinguish between physician-assisted suicide, where the physician helps a patient take his or her own life, and euthanasia, where the physician directly administers the lethal dosage, because prior studies found that attitudes are essentially the same for both.
A majority (58%) of participants disagreed with the statement. Only 20% said that legalizing euthanasia would cause them to trust their personal physician less. These attitudes were the same in men and women.
Older adults (age 65 or older) and blacks were more likely than other groups to say physician aid in dying would lower trust, but this view was still in the minority. Only 27% of older participants and 32% of blacks said euthanasia would lower their trust.
"Despite the widespread concern that legalizing physician-assisted death would seriously threaten or undermine trust in physicians, the weight of the evidence in the United States is to the contrary," says Hall, who acknowledges, nonetheless, that "views vary widely" on the subject.
The debate over physician-assisted death often includes assertions about the impact on patient trust, yet there have been little data on the subject, Hall explains. Two prior studies on the topic were confined to residents of Massachusetts and Iowa, and those results were generally consistent with the findings from this study.
Hall says that public policy advocates often overstate their case when they argue that particular legal or ethical rules are necessary to support trust. Even the U.S. Supreme Court has noted that physician-assisted suicide could "undermine the trust that is essential to the doctor-patient relationship by blurring the time-honored line between healing and harming."
However, he says evidence for this argument is weak.
"Our study shows that only about 20% of people believe they would trust their physician less if euthanasia were legalized," he explains. "The empirical support is weak for those who confidently assert that legalizing physician-assisted death would undermine trust in physicians for most people in the United States."
The authors of the report point out that while those who believe trust would be eroded if physician assisted death were legal are in the minority, physicians "should not be cavalier about potential threats to trust because, once it is lost, it is far harder to rebuild than to sustain." Thus, a ban on physician-assisted suicide or euthanasia could still be justified as a measure to avoid any diminution in trust, they point out.
Source
- Mark A. Hall, JD, professor of law and public health sciences Wake Forest Baptist and Fred D. and Elizabeth L. Turnage Professor of Law at Wake Forest University, Winston-Salem, NC. E-mail: [email protected].
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