Annals of Oncology Advance Access originally published online on June 12, 2008
Annals of Oncology 2008 19(11):1947-1954; doi:10.1093/annonc/mdn381
supportive care and palliative care |
Opinions concerning euthanasia, life-sustaining treatment and acceleration of death: results of an Italian Association of Medical Oncology (AIOM) survey
1 New Drugs Development Unit, Medical Oncology Division, European Institute of Oncology, Milan
2 Department of Oncology, ‘S. G. Calibita’ Hospital, Rome
3 Department of Oncology, General Hospital, Vicenza
4 Department of Oncology, Fatebenefratelli and Ophthalmic Hospital, Milan
5 Oncology Unit, Molinette Hospital, Turin
6 Oncology Unit, ‘M. Paternò’ Hospital, Ragusa
7 Oncology Unit, ‘S. Cuore, Don Calabria Hospital, Negrar
8 Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan
9 Unit for Medical Care European Institute of Oncology, Milan
10 Oncology Unit, National Cancer Research Institute and University of Genoa, Italy
* Correspondence to: Dr C. Catania, New Drugs Development Unit, Medical Oncology Division, European Institute of Oncology, Milan 20141, Italy. Tel: +39-02-57489482; Fax: +39-02-57489581; E-mail: chiara.catania{at}ieo.it
Background: Advance directives, acceleration of death, euthanasia and ‘life-sustaining treatment’ have sparked much heated debate among the media, the public, doctors and political leaders. We evaluate the personal opinions of Italian Association of Medical Oncology (AIOM) members.
Patients and methods: A 30-item questionnaire was developed and delivered to all 1832 AIOM members.
Results: Six-hundred and eighty-five (37%) oncologists completed and returned the questionnaires. Sixty-three per cent felt culturally and psychologically prepared to face these issues. Fifty-four per cent believed that what had been decided while the patient enjoyed good health is no longer applicable in an advanced state of terminal illness. Thirty-nine per cent believed that doctors should abide by these directives, while 49% believed that this should be discussed on a case-by-case basis. Fourteen per cent of oncologists were favourable towards euthanasia and 42% only in particular circumstances. Fifty-six per cent had received at least one request for accelerating death: 15% consented, 50% discussed it with the patient and 31% refused.
Conclusion: Advance directives, euthanasia, accelerated death and life-sustaining treatment represent considerable challenges for Italian oncologists. Although prepared to face these issues, AIOM members ask for a debate within the medical world and for a shared judicial regulation.
Key words: acceleration of death, advance directives, euthanasia, life sustaining treatment, oncological patients
Both authors contributed equally to this work. Received for publication April 22, 2008. Revision received May 7, 2008. Accepted for publication May 8, 2008.