Uncertainty and opposition of medical students toward assisted death practices

To explore medical students' views of assisted death practices in patient c ases that describe different degrees and types of physical and mental suffe ring, an anonymous survey was administered to all students at one medical s chool. Respondents were asked about the acceptability of assisted death act ivities in five patient vignettes and withdrawal of life support in a sixth vignette. In the vignettes, actions were performed by four possible agents : the medical student personally; a referral physician; physicians in gener al; or non-physicians. Of 306 medical students, 166 (54 %) participated. Re spondents expressed opposition or uncertainty about assisted death practice s in the five patient cases that illustrated severe forms of suffering whic h were secondary to amyotrophic lateral sclerosis, treatment-resistant depr essive and somatoform disorders, antisocial and sexually violent behavior, or AIDS. Students supported the withdrawal of life support in the sixth vig nette depicting exceptional futility secondary to AIDS. Students were espec ially opposed to their own involvement and to the participation of non-phys icians in assisted death activities. Differences in views related to sex, r eligious beliefs, and personal philosophy were found. Medical students do n ot embrace assisted death practices, although they exhibit tolerance regard ing the choices of medical colleagues. How these attributes of medical stud ents will translate into future behaviors toward patients and peers remains uncertain. Medical educators must strive to understand the perspectives of physicians-in-training. Expanded, empirically informed education that is a ttuned to the attitudes of medical students may be helpful in fulfilling th e responsibility of imparting optimal clinical care skills. (C) U.S. Cancer Pain Relief Committee, 2001.