Do we need education on right-to-die issues? Medical perspectives from Australia

Abstract

Background: An increasing demand for physicians' involvement in life-ending decisions has led to extensive debate on euthanasia and right to die issues by social, political and medical groups. By definition, suicide prevention experts are considered to be pre-judgmentally biased on these aspects. However, their knowledge of the fields could actually make them important interlocutors in the debate. Aim: As a part of Commonwealth Department of Health and Aged Care's commission, an evaluation of the need for educating undergraduate medical students on suicide prevention, euthanasia and life-ending issues was performed. Methods: In Australia, semi-structured interviews were conducted on samples of medical schools coordinators, medical students, and general practitioners (GPs). Specifically, key academics in Curriculum and /or Accreditation Committees from 10 out of 15 Australian Medical Schools (AMS) participated in a survey on the possible implementation of suicide prevention, euthanasia and life-ending issues in undergraduate courses. University of Queensland medical students (n = 373) were asked to rate their attitude toward the same issues. Twenty four GPs from 6 different states (rural/urban environments) were asked to rate the level of importance of a specific curriculum on suicide prevention, euthanasia and life-ending issues. Results: Suicide prevention education was perceived of critical importance by all. Medical students showed high interest in learning about euthanasia and life-ending issues (76.8%), quality of life and quality of death (85.1%), and different types of euthanasia and physician assisted suicide (70%). They reported that physicians should be involved in ending-life decisions (89%). Forty per cent of AMS thought education on euthanasia and life-ending issues was essential. Fifty four per cent of GPs considered education in euthanasia and related issues as a high priority. Conclusions: The increasing aging population and the high prevalence of chronic illness call for a growing involvement of physicians in this difficult area of medical practice. Globally, the need for undergraduate education on these matters is perceived as important and urgent.