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Palliativmedizinische Lehre

Gibt es einen Einfluss auf die Haltung zukünftiger Ärzte zur aktiven Sterbehilfe?

Tuition in palliative medicine

Does it have an impact on future physicians’ attitudes toward active euthanasia?

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Zusammenfassung

Hintergrund

Diese Arbeit verfolgte das Ziel, die Einstellung von Medizinstudenten mit und ohne Unterricht in Palliativmedizin zu aktiver Sterbehilfe (AS) zu ermitteln und zu untersuchen, ob und inwiefern sich die Haltung im Verlauf des Studiums verändert.

Methode

Entwicklung eines Fragebogens mit 13 Items (Fokusgruppe, Pre-Test), der Fragen nach Wissen und Haltung berücksichtigt. Studenten im 2. (2KS) und 6. (6KS) klinischen Semester an 2 Universitäten (U) mit (U1) bzw. ohne (U2) Palliativmedizin als Pflichtlehr- und -prüfungsfach wurden befragt.

Ergebnisse

Die Befürwortungsrate von AS bei 2KS an U2 und U1 war hoch, blieb an U2 stabil und sank deutlich an U1. An U1 sank der Anteil der Studenten, der für sich selbst AS in Anspruch nehmen würde, stark, an U2 nur wenig. Bei Patienten AS durchzuführen, konnten sich 40,9% (U2) bzw. 22,5% (U1) aller Studenten vorstellen; die große Mehrheit gab an, Ängste vor der Betreuung nicht heilbarer Patienten zu haben. Von den 6KS fühlten sich nur 12,2% an U1 und 7,1% an U2 ausreichend auf die Betreuung sterbender Patienten vorbereitet.

Schlussfolgerung

Diese Befragung konnte einen deutlichen Einfluss des palliativmedizinischen Unterrichts zur ablehnenden Haltung von Studenten zur AS nachweisen; dennoch ist die Pro-AS-Haltung hoch. Die Ergebnisse legen nahe, dass das Lehrangebot an Palliativmedizin modifiziert und wesentlich verstärkt werden muss.

Abstract

Background

The aim of this study was to examine the attitude of medical students with or without tuition in palliative medicine towards active euthanasia and whether this changes during the course of the study period.

Methods

A questionnaire was developed with 13 items (focus groups, preliminary tests) which takes knowledge and attitude into consideration. Students in the 2nd (2CS) and 6th (6CS) clinical semesters at 2 universities with (U1) and without (U2) palliative medicine as a compulsory subject were included.

Results

The initial approval rate for active euthanasia was high for students in 2CS at both universities (U1 and U2), remained stable for U2 and sank clearly for U1. At U1 the number of students who would consider active euthanasia for themselves was greatly reduced but only slightly for U2. Of all the students, 40.9% of U2 and 22.5% of U1 were of the opinion that they could practice active euthanasia on patients. The majority admitted to being frightened to have responsibility for incurable patients. Of the students in 6CS, only 12.2% from U1 and 7.1% from U2 considered themselves sufficiently prepared to be responsible for terminally ill patients.

Conclusions

The results of this questionnaire demonstrated a clear influence of tuition in palliative medicine on the rejection attitude of students towards active euthanasia, however, the attitude proactive euthanasia was still high. The results indicate that tuition in palliative medicine must be modified and substantially intensified.

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Authors and Affiliations

  1. Lehr- und Forschungsstelle, Zentrum für Palliativmedizin, Universität Bonn, Von-Hompesch-Str. 1, 53123, Bonn, Deutschland

    K.E. Clemens, B. Jaspers, E. Klein & E. Klaschik

  2. Abteilung für Anästhesiologie, Intensivmedizin, Palliativmedizin und Schmerztherapie, Malteser-Krankenhaus Bonn/Rhein-Sieg, Bonn, Deutschland

    K.E. Clemens & E. Klaschik

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  1. K.E. Clemens
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  2. B. Jaspers
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  3. E. Klein
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  4. E. Klaschik
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Correspondence to K.E. Clemens.

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Clemens, K., Jaspers, B., Klein, E. et al. Palliativmedizinische Lehre. Schmerz 22, 458–464 (2008). https://doi.org/10.1007/s00482-008-0649-5

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