Orientations, Spectra and Absolutes: An exploration of the attitudes towards assisted dying expressed by respiratory and palliative medicine physicians, and the influence of their professional organisations.

Abstract

Ph. D. Thesis.Background: In the UK, public opinion is largely in favour of assisted dying as a legal right for individuals that wish it, but their view is not mirrored by the medical profession. Amongst doctors, there are varying attitudes, but palliative medicine physicians are the most strongly opposed, compared with those from other medical specialties, including respiratory medicine. Such differences might be explained by examining the characteristics of the people entering each specialty, or by the doctors’ experiences within the specialty. Study aims: (1) To explore and understand differences in opinions about good medical care and assisted dying between palliative and respiratory physicians; (2) To understand the influences that determine these opinions; (3) To conceptualise the relationship between professional organisations and their members regarding the above. Method: This thesis draws on qualitative interview data from specialists in palliative and respiratory medicine, interpreted through thematic analysis. The results are presented in terms of the themes identified through this analysis. In comparing the two specialties, I identified both similarities and differences in their members’ attitudes towards both good medical practice and assisted dying. Findings: I described the similarities between them as absolutes, in that all the physicians held the same view on a particular matter. The differences were identified as orientations, because most of the members of each specialty tended to hold similar views on a particular topic, which were different from those of the other specialty. At an individual level, the orientation would lie on a spectrum which exists between the two most polarised views. This analytical framework offers a new approach to the exploration and understanding of professional values and moral practice in medicine, but it has the potential for a wider application in the sociology of the professions