A Comparative Study To Assess The Knowledge And Attitude Between Postgraduate Nursing Students And Llb Students Regarding Euthanasia In Selected Colleges Of Udupi District

Introduction :

Medical science is progressing in India as in rest of the world, and hence currently we are having devices that prolong life by artificial means. This may indirectly prolong terminal suffering and may also prove to be very costly for the families of the subject in question. Hence end of life issues are becoming major ethical considerations in the modern day medical science in India. In the past few decades, euthanasia has become a widely debated issue across the world. Euthanasia, derived from a Greek term meaning “good death” refers to intentional hastening of death of a patient by the physician with the intent of alleviating suffering¹.

“Euthanasia is a mode or act of inducing or permitting death painlessly as a relief from suffering”. Two types of patients are involved in euthanasia: a patient in a persistent vegetative state who is awake but is not aware of self or the environment, such a patient has no higher brain function and is kept alive on artificial life support and a patient in terminal illness with lots of pain, psychological suffering and loss of dignity. The patient may or may not be on life support².

Euthanasia is generally classified as either active or passive, and voluntary or involuntary. Active euthanasia is taking specific steps to cause the patient's death such as injecting the patient with lethal drugs like Morphine, Phenobarbital etc. passive euthanasia is usually defined as withdrawing medical treatment with deliberate intension of causing patient's death. Voluntary euthanasia is when the patient requests that action be taken to end his life. Involuntary euthanasia is when a patient's life is ended without the patient's knowledge and consent when the patient is not in a state to take a decision on the same, especially children². The objective of the study is to assess and compare the attitude and knowledge of postgraduate nursing students and LLB students towards euthanasia.

Materials and methods :

After obtaining the administrative permission from the authority, ethical clearance was obtained. Consent was taken from the participants of the study.

40 postgraduate nursing students and 40 final year LLB students were selected by non-probability purposive sampling technique. Tools used for the study were demographic proforma, structured knowledge questionnaire on euthanasia and an attitude scale. Knowledge scores were classified into three categories-poor (0-5), average (6-10), and good (11-15). Attitude scale was arbitrarily classified as not favouring (10-23), favouring (24-36) and strongly favouring (37-50). Obtained data was analysed by using descriptive statistics (mean, mean percentage, standard deviation) and inferential statistics (independent sample t-test).

Results :

The study findings reveal that majority, (57.5%) of the postgraduate nursing students were Christians and majority, (85%) of the LLB students were Hindus. Majority, (80%, and 60%) of the postgraduate nursing and LLB students were females respectively.

The result also shows, 60% of the postgraduate nursing students and 62.5% of the LLB students had good knowledge and 2.5% of the postgraduate nursing students and 7.5% of the LLB students had poor knowledge regarding euthanasia respectively. The study also reveals that 65% of the postgraduate nursing students and 57.5% of the LLB students were favouring euthanasia, 7.5% of the postgraduate nursing students and 2.5% of the LLB students were strongly favouring euthanasia. 27.5% of the postgraduate nursing students and 40% of the LLB students were against euthanasia respectively. Comparison of knowledge of postgraduate nursing students and LLB students regarding euthanasia was done by computing independent t-test and found that there was no significant difference between the knowledge of postgraduate nursing students and LLB students.

Discussion :

The study results shows that 72% of the postgraduate nursing students and 60% of the LLB students were favouring euthanasia. This study is supported by a study conducted by Els Inghelbrecht, Johan Bilsen, Freddy Mortier and Luc Deliens to investigate the attitude of nurses towards euthanasia and the result reveals that 92% of the nurses accepted euthanasia for terminally ill with extreme pain or other distress and 57% accepted the administration of lethal drugs for the patients who suffer unbearably and not capable of decision making³.

A qualitative study was carried out in Brazil to assess the nurses' perception on dysthanasia, euthanasia and orthonasia and care implications. 27 nurses'' were included in the study. None of the nurses' were able to explain euthanasia, 50% were able to explain dysthanasia and only one third of the samples were able to explain orthonasia. This study is contradicting with the present study findings as 60% of nurses' and 62% of LLB students are having good knowledge on euthanasia⁴.

Conclusion :

The findings of the study indicated that nursing and LLB students have good knowledge on euthanasia. Studies can be conducted among general population to assess the knowledge and attitude and awareness programs can be conducted to educate the public regarding euthanasia.