title: Psychosocial determinants of physicians' intention to practice euthanasia in palliative care.
abstract: BACKGROUND
  Euthanasia remains controversial in Canada and an issue of debate among physicians. Most studies have explored the opinion of health professionals regarding its legalization, but have not investigated their intentions when faced with performing euthanasia. These studies are also considered atheoretical. The purposes of the present study were to fill this gap in the literature by identifying the psychosocial determinants of physicians' intention to practice euthanasia in palliative care and verifying whether respecting the patient's autonomy is important for physicians.
  
  
  METHODS
  A validated anonymous questionnaire based on an extended version of the Theory of Planned Behavior was mailed to a random sample of 445 physicians from the province of Quebec, Canada.
  
  
  RESULTS
  The response rate was 38.3% and the mean score for intention was 3.94 ± 2.17 (range: 1 to 7). The determinants of intention among physicians were: knowing patients' wishes (OR = 10.77; 95%CI: 1.33-86.88), perceived behavioral control-physicians' evaluation of their ability to adopt a given behavior-(OR = 4.35; 95%CI: 1.44-13.15), moral norm-the appropriateness of adopting a given behavior according to one's personal and moral values-(OR = 3.22; 95%CI: 1.29-8.00) and cognitive attitude-factual consequences of the adoption of a given behavior-(OR = 3.16; 95%CI: 1.20-8.35). This model correctly classified 98.8% of physicians. Specific beliefs that might discriminate physicians according to their level of intention were also identified. For instance, physicians' moral norm was related to the ethical principle of beneficence.
  
  
  CONCLUSIONS
  Overall, physicians have weak intentions to practice euthanasia in palliative care. Nevertheless, respecting patients' final wishes concerning euthanasia seems to be of particular importance to them and greatly affects their motivation to perform euthanasia.
authors.affiliation: Faculty of Nursing, Laval University, Québec, G1V 0A6, Canada. mireille.lavoie@fsi.ulaval.ca.|Équipe de Recherche Michel-Sarrazin en Oncologie psychosociale et Soins palliatifs (ERMOS), Centre de recherche du CHU de Québec - Hôtel-Dieu de Québec, Québec, Canada. mireille.lavoie@fsi.ulaval.ca.
authors.forename: Mireille
authors.initials: M
authors.lastname: Lavoie
authors.affiliation: Faculty of Nursing, Laval University, Québec, G1V 0A6, Canada. gaston.godin@fsi.ulaval.ca.
authors.forename: Gaston
authors.initials: G
authors.lastname: Godin
authors.affiliation: Faculty of Nursing, Laval University, Québec, G1V 0A6, Canada. lydi-anne.vezina-im@fsi.ulaval.ca.
authors.forename: Lydi-Anne
authors.initials: LA
authors.lastname: Vézina-Im
authors.affiliation: Faculty of Nursing, Laval University, Québec, G1V 0A6, Canada.
authors.forename: Danielle
authors.initials: D
authors.lastname: Blondeau
authors.affiliation: Maison Michel-Sarrazin, Quebec, Canada. imartineau@michel-sarrazin.ca.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Martineau
authors.affiliation: CHU de Québec - Hôpital Enfant-Jésus, Quebec, Canada. Louis.Roy@ssss.gouv.qc.ca.
authors.forename: Louis
authors.initials: L
authors.lastname: Roy
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D026686:Beneficence; D003657:Decision Making; D005065:Euthanasia / Q000941:ethics; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D009042:Motivation; D016017:Odds Ratio; D010166:Palliative Care; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D010820:Physicians / Q000941:ethics / Q000523:psychology; D010818:Practice Patterns, Physicians'; D011792:Quebec; D012927:Social Control, Informal; D011795:Surveys and Questionnaires; D013727:Terminal Care