NZ Med students become more opposed to euthanasia while at uni

New Zealand Medical students become more opposed to euthanasia as they progress through medical school, a new study has found.

Almost 65 per cent of second year medical students at Otago University supported euthanasia or assisted dying, compared with 39 per cent in fifth year, the researchers found.

Support for the practice fell over each year of training: 64.8 per cent in support in second year, 62.6 per cent in third year, 51.5 per cent in fourth year and 39.1 per cent in fifth year.

We suggest that this difference is most likely due to their time in medical education,” concluded Luke Nie​ and Simon Walker​, along with two other Otago researchers.

The structure of medical school was likely a factor, Walker said in an interview.

First and second year students see few patients and their views mirrored the results of the End of Life Choice referendum held last November – 65 per cent in favour of legalisation, 34 per cent opposed.

By fifth year, however, med students are seeing lots of patients and are “confronted… by the complexities” that can come up in end-of-life situations, he said.

Otago med students are taught palliative medicine and end-of-life care as a “vertical module” throughout most of their education. They also get bioethics courses, although those are mostly identifying issues and enabling students to think for themselves, Walker said. He is a bioethicist and teaches some of these neutral classes.

Professors, doctors and nurses with strong views on euthanasia also probably made impressions on the students, he said.

Also, these young people – most are in their 20s – were “working out how to survive in the profession and that requires a kind of conformity”, Walker said.

Because most respondents were young, the results pretty much ruled out age as a factor.

Ending a life was “contrary” to what med students were trying to become, he said. “Their whole orientation is to try and make things better, and ending a person's life doesn't feel that way.”

Surveys of working doctors have showed they oppose, by wide margins, what the New Zealand Medical Association calls “doctor-assisted suicide”.

A 2018 survey of 298 working doctors, for example, found 34.5 per cent would be willing to prescribe lethal medication, a percentage not far off the Otago student survey.

Luke Nie​ initiated the student survey in 2018, when he was a second-year med student at Otago. Now in fifth year medicine, he will survey his peers again this year to track changes. Deeper interviews with a small group will also be repeated.

Walker hoped the new survey would provide greater insights into how med students are thinking through assisted death and the major factors affecting their positions.

He expected to see them raise ethical concerns. But he also expected awareness that assisting death was a “hard thing to do and a hard thing to be involved with”.

The End of Life Choice Act comes into force in November, meaning these students will soon graduate into a New Zealand where assisted death is legal and sought. It will no longer be a hypothetical.

Internationally, similar surveys of med students have produced mixed results – some showing a similar trend to Otago and others showing little change in their views. But differing methodologies made comparisons difficult.

A total of 326 of the 1152 Otago students answered the survey, or 28 per cent.

The study was published in the peer-reviewed, open access journal, BMC Medical Education.

THIS STORY WAS ORIGINALLY PUBLISHED HERE