12% of doctors polled say they have faced requests for euthanasia

Just over one-half of 356 doctors from various fields polled by researchers for the Malta Medical Journal said they agree with intensifying analgesia at the end of life with the possibility of hastening death.

But only six in 100 would sedate patients at the end of life to hasten death, according to the study conducted by Pierre Mallia and Jurgen Abela in 2013 and published in the latest edition of the MMR.

The study also shows that 32.1% of Maltese doctors have also withdrawn or withheld treatment to terminally ill patients. 

When asked whether they ever received a request for euthanasia from patients, 11.9% answered positively. 

But a very solid majority (90.2%) of doctors are against euthanasia.

This contrasts with a MaltaToday survey published in March which showed 53% of the general population agreeing with euthanasia, in cases involving people suffering pain from a terminal illness. Debate on this topic intensified following an interview published in MaltaToday with ALS sufferer Joe Magro in February. 

Magro was diagnosed with ALS, a deadly neurodegenerative disease that affects nerve cells in the brain and the spinal cord, a year ago. 

“I do not want to be a burden on anyone. I do not want to be dependent on my family to eat, drink, wash or simply go to the bathroom. I will live as long as I can but once it gets to a point where I cannot live life in dignity I will commit suicide,” he said in the interview.

The latest study notes that while doctors are in favour of intensification of analgesia (using opiods) even if this might theoretically impact the length of survival of the patient, they strongly support the statement that physicians should always aim to preserve life. 

The study shows that most doctors are guided by their religious beliefs when it comes to end of life (EoL) care. 47% replied that religion is “very important” when making decisions on end of life.

“Doctors believe in preserving life as a guiding principle at the end of life, but do not shun intensification of analgesia at the end of life”. 

The questionnaire was sent by post to all medical practitioners who were listed on the Principal Register of the Medical Council of Malta as on November 2013. 396 doctors returned the questionnaire, giving a response rate of 39.3% 

The study concludes that doctors commonly face end of life decisions. In general, they find this topic difficult and challenging and rely on their religion as the major source of guidance. 

The study refers to the absence of a legal framework and official guidance on this topic, which further adds to the difficulty in such situations. 

“There needs to be broad guidance to doctors in such situations to support them better.”

A survey of 160 general practioners published last year had revealed that over 14% of them received requests for euthanasia from their ailing patients. 41.1% of the 160 doctors surveyed had intensified analgesia at the end of life, but only 7.5% had sedated patients. 15% of GPs withdrew or withheld treatment in the care of these patients.