How Does Medical Education Affect Students’ Views of Euthanasia/assisted Dying? A Mixed-method Study

Abstract Background Previous studies report a majority of the general public support euthanasia/assisted dying (EAD), while a majority of doctors are opposed. In considering policy decisions about EAD, some may discount the views of doctors because they take them to be based on personal values or tradition, rather than reasons that the general public might share. One way to explore this notion is to examine whether medical students’ views change during medical education. The objective of this study was to learn how New Zealand medical students view EAD and whether their views change during medical education. MethodsAn on-line survey of undergraduate medical students was conducted. Quantitative data was analysed using unadjusted and multiple logistic regression. Thematic analysis was conducted with the qualitative data.Results A total of 326 students replied to the survey. The overall response rate was 28%. 65% of 2nd year students were supportive of EAD, compared to 39% in 5th year. The odds of 5th year students supporting a law change compared to 2nd year was 0.30 (95%CI 0.15-0.60). The predominant themes found in the qualitative results indicate that medical students support or oppose EAD for reasons similar to those found in the wider debate, and that their views are influenced by a range of factors. However, several at all year levels cited an aspect of medical school as having influenced their views. This was mentioned by participants who were supportive of, opposed to, or unsure about EAD, but it was the type of influence most often mentioned by those who were opposed. ConclusionsThe quantitative findings suggest that aspects of medical education made students less likely to support EAD. The qualitative findings indicate that this is not related to a single educational experience at Otago Medical School but a range. Together, these findings suggest that the lower support found among doctors is in part related to medical education and medical work rather than age, personality, or social context. They indicate a practical basis to ethical and professional formation that should be considered in curriculum design, policy decisions and when interpreting public opinion surveys on this issue.