Table 2 Summary of studies predicting euthanasia or motivation to perform euthanasia

Asch & DeKay [20]

United States

Behavior

1 139 critical care nurses:

N/A

73%

• Euthanasia and PAS are unethical (-)

Age: 38.5 (8.7)

• Passive euthanasia is unethical (-)

5.1% male

• Working in cardiac care unit (-)

• Ever asked to engage in euthanasia (+)

Back et al. [21]

United States

Behavior

828 physicians (GPs and specialists):

N/A

57%

Reasons for not providing euthanasia:

Age: NR

• Physicians should never perform euthanasia

76.3% male

• The symptoms were potentially treatable

• The duration of the patient survival was expected to be > 6 months

• The patient was depressed

• The degree of patient suffering did not justify the request

• Worried about legal consequences

Davis et al. [22]

Australia, Canada, China, Finland, Israel, Sweden and United States

Behavior

168 cancer care nurses:

N/A

N/A

• Patient wish

Age range: 19-64

• Severe suffering

% male: NR

• Terminally ill

• Family agree

DeKeyser Ganz & Musgrave [23]

Israel

Behavior

71 critical care nurses

N/A

N/A

Religiosity (-)

Doukas et al. [24]

United States

Behavior and intention (willing)

154 oncologists:

Belief-attitude-intention-behavior model of Fishbein

61.6%

Behavior:

Age: 49

• University-based oncologists have administered (+)

83% male

Intention:

• University-based oncologists willing (+)

• Religion (+/-)

• Global attitude scale (+)

• Philosophical scale (+)

• Alternative attitude scale (+)

Essinger [25]

United States

Intention (willingness)

365 physicians (GPs and specialists):

N/A

34%

• Deliberate administration of an overdose is never ethically justified

Age: 48.7

84.7% male

• Euthanasia is inconsistent with the physician’s role to relieve pain and suffering (-)

• Religion (-)

Folker et al. [26]

Denmark

Behavior

314 physicians (21% GPs):

N/A

64%

• Euthanasia is ethically acceptable

Median age: 47

• Euthanasia would make me feel uncomfortable

69% male

• Euthanasia is incompatible with my role as a physician

Inghelbrecht et al. [42]

Belgium (Flanders)

Intention (never prepared to administer lethal drugs)

3321 nurses:

N/A

62.5%

• Sex: women vs. men (+)

77% older than 36 years

• Education: baccalaureate vs. diploma (-)

12.4% male

Master vs. diploma (-)

• Religion: Catholic vs. non-religious (+)

Protestant vs. non-religious (+)

Other religion vs. non-religious (+)

• Work setting: home care vs. other (+)

• Experiences with end-of-life decisions with 3 or more patients: yes vs. no (-)

Kinsella & Verhoef [27]

Canada

Intention (willingness to practice euthanasia if it were legalized)

1391 physicians (GPs and specialists):

N/A

69%

• Sex (+)

51% over the age of 40 years

• Religious affiliation and activity (+)

78% male

• Country of graduation (+)

Kohart [28]

United States

Behavior

93 physicians (GPs and specialists):

N/A

42.1%

• Relieve patient pain

Age: 47

• Patient’s desire to die

95.7% male

• Reallocate resources

• Relieve family concern

Kuhse & Singer [29]

Australia

Behavior

869 physicians (GPs and specialists):

N/A

46%

• Euthanasia is not the doctor’s role

Age range: < 30 to > 60 years

• Euthanasia was the right thing

78.5% male

• Respecting the patient’s wish

• It is right for a doctor to take active steps to bring about the death of a patient who has requested the doctor to do this

Kuhse & Singer [30]

Australia

Behavior and intention (willingness)

943 nurses:

N/A

49%

Behavior:

40% of respondents are in their 30s

• Euthanasia was the right thing

6% male

• Patient request

• Discussion with the family

• Age

• Religion

Intention:

• Age

Kunene & Zungu [31]

South Africa

Behavior

26 nurses:

N/A

100%

12% would administer a lethal dose of a drug in order to relieve suffering

Age: NR

8% male

Maitra et al. [32]

Germany

Behavior and intention (willingness)

233 GPs:

N/A

48%

Behavior:

Age: 51

• Euthanasia was right in a moral sense

68% male

• Have received requests for euthanasia in the past (+)

Matzo [33]

United States

Behavior

441 oncology nurses:

N/A

74%

• Being married (0)

Age: 42.0 (8.5)

• Being Jewish (0)

2% male

• Being Catholic (0)

• Income (0)

• Race (0)

• Age (0)

• Religiosity (0)

• Gender (0)

• Highest degree (0)

• Years since graduation (0)

• Catholic religiosity (0)

• Jewish religiosity (0)

Meeusen et al. [43]

Belgium

Behavior

205 GPs:

N/A

91.9%

Reasons for granting a patient’s request:

Age: NR

• Explicit & repeated request from patient

% male: NR

• Written request

Reasons for not granting a patient’s request:

• Patient’s wish was not explicit & repeated

• Patient’s suffering was not unbearable & persistent

Meier et al. [34]

United States

Behavior

379 physicians:

N/A

63%

• Patient depressed at the time of request (-)

Age: NR

• Patient in severe discomfort other than pain (+)

% male: NR

• Patient life expectancy < 1 month (+)

Obstein et al. [44]

The Netherlands

Behavior

30 physicians:

N/A

100%

• Positive experience with euthanasia

Age: 49.3

• No regrets after performing euthanasia

86.7% male

• Euthanasia is part of the role of a physician

• Euthanasia challenges personal morals

Onwuteaka-Philipsen et al. [35]

Australia, Belgium, Denmark, Italy, The Netherlands, Sweden and Switzerland (before 2002)

Intention (willingness to perform end-of-life decisions)

10 139 physicians (GPs and specialists):

N/A

57.1% (overall)

• Request of patient with decisional capacity (+)

Age: NR

• Advance directive of subcomatose patient (+)

% male: NR

• Request of family of patient with decisional capacity (-)

• Subcomatose patient, request of the family (+)

• Subcomatose patient, own initiative of physician (+)

• Life expectancy < 2 weeks (+)

• Uncontrollable pain (+)

• Religious, important for professional attitude (-)

Onwuteaka-Philipsen et al. [45]

The Netherlands

Behavior

6263 physicians (GPs and specialists):

N/A

74%

Reasons for granting requests:

Age: NR

• Wish of the patient

% male: NR

• No prospect of improvement

• No more options for treatment

• Loss of dignity

Oz [36]

Turkey

Behavior and intention (willingness)

113 nurses:

N/A

Nurses: 39% Physicians: 31.8%

Nurses’ willingness to participate in legal euthanasia:

Age: 78% between 20-30

• Age (0)

0% male

Physicians’ willingness to participate in legal euthanasia:

84 physicians:

• Age: 20-30 vs. 31+ (+)

Age: 65.5% between 20-30

Nurses’ reasons for wanting to make their patient’s death easy according to years of experience:

79.8% male

• Pain and depression: 7+ years vs. 1-6 years (+)

Physicians’ reasons for wanting to make their patient’s death easy according to years of experience:

• Pain and depression: 1-6 years vs. 7+ years: (+)

• Insufficient support: 7+ years vs. 1-6 years (+)

Parker et al. [37]

Australia

Intention (willingness)

1478 physicians (GPs and specialists):

N/A

53%

Case 1: competent patient, life expectancy < 2 weeks: Anesthetists vs. palliative care specialists and oncologists (+)

> 70% aged 40 or more

Case 2: competent patient, life expectancy > 3 months: Anesthetists vs. palliative care specialists and oncologists (+)

78% male

Case 3: incompetent patient, life expectancy < 2 weeks:

Anesthetists vs. palliative care specialists and geriatricians (+)

Case 4: incompetent patient, life expectancy > 3 months: Anesthetists vs. palliative care specialists and geriatricians (+)

Richardson [38]

United States

Behavior and intention (attitude)

148 oncology nurses:

Kohlberg’s model of moral reasoning development

74%

Behavior:

Age: NR

• Religious attitude to euthanasia (-)

% male: NR

Shapiro et al. [39]

United States

Intention (willingness)

740 physicians (GPs and specialists):

N/A

33%

Willingness to perform euthanasia:

Age: 55.1% between 35-60

• Family/general practice vs. other specialty or internal medicine (+)

84% male

• Christian fundamentalists vs other religions (Protestant, other) (-)

• Catholic vs. other religions (Protestant, other) (-)

• Jewish vs. other religions (Protestant, other) (+)

• Specified no religion vs. other religions (Protestant, other) (+)

Willingness to perform euthanasia if it were legalized:

• Family/general practice vs. other specialty or internal medicine (+)

• Christian fundamentalist vs. other religions not in analysis (-)

• Catholic vs. other religions not in this analysis (Protestant, other), and for uncertain outcome (Christian fundamentalist, Jewish) (-)

• Jewish vs. other religions not in this analysis (Protestant, other) (+)

• Specified no religion vs. other religions not in analysis (+)

Smets et al. [46]

Belgium

Behavior

914 physicians (GPs and specialists):

N/A

34%

Religious affiliation/philosophy of life:

Age: 45.1% between 51-65

• Roman Catholic/strong practicing vs. not religious (-)

63.5% male

• Roman Catholic/moderately practicing vs. not religious (-)

• Roman Catholic/not practicing vs. not religious (-)

• Religious, but no specific denomination vs. not religious (-)

Specialty:

• Specialist vs. general practitioner (+)

Age (years):

• 36-50 vs. < 35 (+)

• 51-65 vs. < 35 (+)

• > 65 vs. < 35 (+)

Training in palliative care: yes vs. no (+)

Number of terminal patients cared for in the last 12 months:

• 1-9 vs. 0 (+)

• ≥ 10 vs. 0 (+)

Stevens & Hassan [40]

Australia

Behavior

298 physicians:

N/A

68%

Strong association between taking active steps and belief that such action was ‘right’

Age: NR

Reasons why they felt they had done the ‘right’ thing:

% male: NR

• This action had relieved pain, suffering and distress experienced by the patient

• The patient was near death

• The situation was hopeless

• The patient had no prospect of a meaningful or independent existence

• Acted on orders

Stevens & Hassan [41]

Australia

Behavior

278 nurses:

N/A

55%

Sex: male vs. female

Age range: 20-59

6.5% male