Attitudes of Sri Lankan physicians towards end oflife decisions and care

Abstract

INTRODUCTION: Despite considerable public interest in legalizing physician-assisted suicide and euthanasia in many parts of the world, littie is known about physicians' attitudes toward these practices in Sri Lanka. OBJECTIVE: To assess attitudes of physicians towards end of life care and decision making. DESIGN, SETTING AND METHODS: Data were collected using a pre-tested self-administered questionnaire distributed among 450 physicians and aspiring physicians attending two Annual Academic Sessions. RESULTS: Sixty-six consultant physicians and 204 non-consultant doctors responded to the questionnaire (60% response rate). 262 (97%) were in agreement of palliative care and 63 (23%) of them believed in delivering the best possible care for the terminally ill. 218 (81%) indicated that they would use morphine as a mode of pain relief. But only 51 (19%) doctors said they would administer morphine knowing that it might cause death due to respiratory depression, implying their agreement to the concept of the 'doctrine of double effect'. More consultants [43 (65%)] than other doctors [80 (40%)] would give a 'do not resuscitate" order (p<0.01). Only 30 (11%) of all doctors agreed with active euthanasia or physician-assisted suicide in some instances; the majority [207 (76%)] disagreed with any form of active euthanasia (morally and ethically) for terminally ill patients, even when patients request it. CONCLUSIONS: The majority Sri Lankan physicians are in favour of palliative care for terminally ill patients. More consultants than other doctors would give a 'do not resuscitate' order. The majority would not offer any form of active euthanasia and believe it is morally and ethically incorrect.