Abstract

Background: The moral and ethical issues surrounding medical termination of life have been openly and extensively discussed over the past 25 years. As medicine has increasingly enabled the chronically ill to live longer lives of dubious quality, euthanasia has become a more actively debated issue. Although the primary focus of medical care is saving life and treating diseases to enhance the quality of life, requests for medical practitioners to end life are not rare. Although euthanasia and assisted suicide are illegal in most countries, they are legal in Belgium, the Netherlands, and the state of   Oregon in the United States of America. In Iraq, euthanasia and assisted suicide are illegal. Neither the lay community nor the medical profession has been exposed to the international debate on these issues. Subjects and methods:  A cross-sectional survey using an anonymous self –administered questionnaire, which consists of 25 items was conducted among 456 physicians working in 5 selected governmental hospitals and primary health care centers. The method of data collection was a self-administered questionnaire consisting of 3 main sections. The first section, composed of  7 questions, covered the physician’s characteristics. The second section elicited physicians’ knowledge about euthanasia through   3 questions. The third section focuses on the attitude of physicians through 15 questions. Results: Out of 600 physicians (study population) who received the questionnaire, only 456 physicians responded with a response rate of 76%. Two-thirds of the respondents (66%) were unfamiliar with the term euthanasia (mercy-killing), and most of the familiar other third reported that their source of knowledge about euthanasia was the internet 40%, professional magazines 33%, and press/ media 27%. About 95% of doctors stated that there was no formal teaching or extra-curriculum sessions about the end–of–life decisions and euthanasia at their medical colleges.  The majority (92%) of all the respondents did not support the provision of means for terminally ill patients to commit suicide, while 8% did. A considerable proportion favored providing painkillers and comfort even if this hastens the death of the patient. About 13% of doctors felt the Authority or the Ministry of Health should allow euthanasia under certain restricted conditions. Nearly 10% of Muslim physicians agreed to the legalization of euthanasia, while 49% of non-Muslim doctors agreed to the same issue. Approximately 27% of physicians who were frequently exposed and   10% of those who were rarely exposed to terminally ill patients reported that they had been asked to hasten death. Physicians in Iraq have not dealt with mercy–killing as much as physicians in other countries such as Australia and are much less favorable towards it. Conclusions: The majority of the study population reported that they received no formal teaching or extra-curricular sessions about euthanasia. The findings of this survey indicate that a minority of doctors in Iraq believe that euthanasia should be legalized under certain restricted conditions. Modernization of the curriculum of our medical schools to thoroughly cover the issues of end–of–life decisions is indicated.  Also, there is a need for the medical community and the Ministry of Health to recognize and deal with this controversial topic, and there is a necessity to initiate a medico-legal debate in order to clarify related issues and choose or decide what is best