An increasing number of individuals with dementia express a wish for euthanasia, the deliberate act of terminating life through the administration of drugs, to hasten their death. Yet, physicians...Show moreAn increasing number of individuals with dementia express a wish for euthanasia, the deliberate act of terminating life through the administration of drugs, to hasten their death. Yet, physicians remain hesitant to perform the procedure. Research suggests that the emotional challenges of administering euthanasia contribute to this reluctance. In this cross-sectional study, multinominal logistic regression analyses were employed to assess whether physicians better equipped to handle these challenges through active coping strategies are more willing to administer euthanasia to dementia patients, as well as a potential mediating role of internal Locus of Control (LoC). The study involved 203 physicians (108 females, 95 males) from six countries (US, the Netherlands, Israel, Japan, Germany, Switzerland) who practice end-of-life care for dementia patients. Participants took part in a 60-minute assessment that included an animation video vignette to assess their opinions on euthanasia in dementia cases, as well as a survey. Contrary to expectations, no association was found between active coping strategies and physicians’ willingness to administer euthanasia in dementia cases (X² (2, N = 203) = 2.22, p = .33). There was also no relationship between internal LoC and physicians' willingness to administer euthanasia in dementia cases (X² (2, N = 203) = 0.07, p = .97), nor any mediation effect of internal LoC (R² = .005, p =.31). A positive correlation between active coping and internal LoC was observed (r = .12, p = .001). Additionally, post-hoc analyses revealed a significant influence of country on physicians’ willingness (X² (10, N = 203) = 33.56, p < .001). The findings of this study highlight the importance of exploring a broader range of factors influencing physicians’ willingness, such as experience with previous euthanasia requests, as well as the need for country-specific analyses. Future studies should adopt a multifactorial design to better understand the complexities of physicians' willingness to administer euthanasia in dementia cases.Show less
In this thesis, the gap between a steady and overwhelming majority of the British public in favour of legalisation of PAS and a political unwillingness to change the legal status quo is explored....Show moreIn this thesis, the gap between a steady and overwhelming majority of the British public in favour of legalisation of PAS and a political unwillingness to change the legal status quo is explored. The question that stands central in this historically uncharted topic is how this majority of public opinion was perceived and used in the parliamentary debates on PAS in both the HOL and HOC and how it has influenced these debates over time (1993-2015). From the first two chapters it becomes clear that mounting public pressure via media, lobby groups and court rulings resulted in multiple efforts through PMB’s to legalise PAS. In that sense, public pressure was already an influential factor in bringing about political debate and attention to the subject. It is further argued that from 2003 onwards the question of which role public opinion on PAS should play in the decision making provided for an authoritarian/liberal line of conflict. Lords and MP’s increasingly considered the argument that a majority of the public was in favour of PAS as one of the most important or in some cases even as a foundational justification to legitimise their claim for legalisation of PAS. These representatives were supporters of the concepts of liberty and autonomy of the individual to determine one’s own destiny. However, representatives opposing PAS in both Houses on the other hand showed a total distrust of the public opinion. They denied any involvement of public opinion on the decision making process and even found it potentially dangerous for policy making. They showed an authoritarian and superior attitude towards the ability of the public in making an informed decision on PAS. The increase in MP’s and Lords voting against PAS in the researched period shows that despite this intensive and growing debate on public opinion in parliament, public pressure has not been able to bend voting in favour of a majority.Show less
