title: Euthanasia, assisted suicide and end-of-life care: attitudes of students, residents and attending physicians.
abstract: BACKGROUND
  Attitudes in regard to end-of life issues are evolving in Western societies. We have sought to trace this evolution in the relatively homogeneous cultural setting of Puerto Rico.
  
  
  METHODS
  One hundred fifty-two medical students, 62 medical residents and 84 members of three medical faculties were asked whether in terminally ill patients they: 1) would support a request for euthanasia(E); 2) if legalized, would engage in, would oppose or would not be opposed to others engaging physician-assisted suicide(PAS); 3) would consider ethical to prescribe full doses of drugs needed to alleviate pain, even if they knew it would hasten death; 4) would agree to limit certain resources for the terminally ill. Gender and religious affiliation were also requested.
  
  
  RESULTS
  Twenty-eight percent of the students, 26% of the residents and 31% of the faculty supported E. Only 13% of the students, 18% of the residents and 11% of the faculty would engage in PAS. Men were more willing than women to acquiesce to a request for E or PAS. Religious affiliation or its absence did not influence the support or opposition to E and PAS. If it would hasten death, 86% of the residents, but only 65% of the faculty considered ethical to prescribe the dose of drugs needed to alleviate pain. More than 2/3 of the students, residents and faculty favored the limiting of certain resources for the terminally ill.
  
  
  CONCLUSIONS
  In our cultural and medical environment, men are more willing than women to engage in E or PAS. The attitude towards E and PAS is not influenced by religious affiliation. If it hastens death, some still consider unethical to prescribe full doses of drugs needed to alleviate pain in the dying patient.
authors.affiliation: Universidad Central del Caribe, San Juan, PR 00920-4361. ramirj@hotmail.com
authors.forename: José
authors.initials: J
authors.lastname: Ramírez-Rivera
authors.forename: Juan
authors.initials: J
authors.lastname: Cruz
authors.forename: Francisco
authors.initials: F
authors.lastname: Jaume-Anselmi
mesh_terms: D001291:Attitude of Health Personnel; D005065:Euthanasia; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital; D013337:Students, Medical; D017236:Suicide, Assisted; D011795:Surveys and Questionnaires; D013727:Terminal Care