THE CHILD WITH
TERMINAL ILLNESS AND THE PROBLEM OF EUTHANASIA: A SURVEY AMONG HEALTH
SERVICES PERSONNEL AND USERS
Garduño
EA,
Garduño EJ, Zavala GM, Heshiki NL, Mexía HJ.
Department
of Continuous Medical Education. Instituto Nacional
de Pediatría
Mexico City, Mexico
Objective: To know the opinions of
medical personnel concerning child health and of health care users with
respect to the treatment that children with terminal illness should receive
and also with respect to the problem of euthanasia.
Material and Method: Descriptive and
prolective survey with the use of a questionnaire among 296 persons, 173
females and 118 males. There were 71 medical residents, 154 staff
physicians, 52 medical interns, 57 nurses and 51 members of the community,
users of health services.
Results: 88 percent of the
persons surveyed practiced some type of religion; most were catholic. 48
percent of the doctors indicated that life should be prolongued only if its
quality was good; this same thought was expressed by 30 percent of the
nurses and by 51 percent of the users. On the other hand, 16 percent of the
doctors, 37 percent of the nurses and 29 percent of the users indicated
that every effort should be made to prolong life. Those in favor of
implementing palliative treatment were 21 percent of the doctors, 11
percent of the nurses and 9 percent of the users. Of those who filled in
the questionnaire, 46 percent were in favor to be absolutely truthful with
children; 45 percent preferred to tell the partial truth. 69 percent of the
survey indicated that people were in favor of having the children
participate in therapeutic decisions whereas 80 percent were in favor of
the participation of parents in therapeutic decisions. 95 percent of health
care personnel agreed that there is the need for psychological support and
99 percent in allowing religious support when requested. 75 percent of the
doctors, 68 percent of the nurses and 45 percent of the users indicated
that cardiopulmonary support is not justified in these children. Over 80
percent of the participants were in favor of the idea that death of
patients should occur in the home, surrounded by relatives. 61 percent of
the nurses and 59 percent of the users agreed that euthanasia does not go
against the dignity of the person. 52 percent of the doctors, 40 percent of
the nurses and 51 percent of the users believe that euthanasia should be
legalized in Mexico.
Conclusions: In view of the
possibility of facing death with a spirit of therapeutic obstination,
euthanasia has been gaining acceptance among medical staff personnel and
paramedics while ignoring the benefits of palliative medicine.