Article

Palliativmedizinische Lehre

Malteser-Krankenhaus Bonn/Rhein-Sieg Abteilung für Anästhesiologie, Intensivmedizin, Palliativmedizin und Schmerztherapie Bonn Deutschland
Der Schmerz (Impact Factor: 1.5). 08/2008; 22(4):458-464. DOI: 10.1007/s00482-008-0649-5

ABSTRACT HintergrundDiese 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.

MethodeEntwicklung 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.

ErgebnisseDie 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.

SchlussfolgerungDiese 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.

BackgroundThe 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.

MethodsA 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.

ResultsThe 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.

ConclusionsThe 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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