Medical Students’ Perspective on Euthanasia in Calabar, Nigeria: A Cross-Sectional Study

Medical Students’ Perspective on Euthanasia in Calabar, Nigeria: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Medical Students’ Perspective on Euthanasia in Calabar, Nigeria: A Cross-Sectional Study Emmanuel Aniekan Essien, Precious Miracle Wagwula, Chelsea Chioma Ukanwoke, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6749981/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 16 You are reading this latest preprint version Abstract Background : As future doctors, medical students are often confronted with the topic of euthanasia while fulfilling their roles in caring for terminally ill patients. Despite the complex ethical, legal, and cultural debates surrounding euthanasia globally, the attitudes of medical students towards it remain unexplored in Nigeria. This paper aims to investigate medical students' attitudes towards euthanasia. Methodology : A cross-sectional study was conducted among 126 clinical students at the University of Calabar's Faculty of Clinical Sciences. The sample size was determined using the Taro Yamane formula. Participants were selected using simple random sampling and were administered a sociodemographic questionnaire and the Euthanasia Attitude Scale (EAS). Data was analyzed using IBM SPSS version 26. Results : The sample's mean age was 23.9 (2.74) years, and more were female (54.5%). We found that 68.6% believed in the patient’s right to choose euthanasia in terminal illnesses, and 65.3% saw its utility in specific contexts. Over half (56.2%) supported societal acceptance of euthanasia, especially when recovery was impossible (53.7%) or to reduce family burden in terminal cases (50.4%). Regarding conditions for euthanasia, most opposed using terminal illness (47.9%) or old age (43.0%) as general criteria, while57.9% feared it would be abused. Conclusion : The study concludes that medical students at the University of Calabar hold a nuanced view towards euthanasia, predominantly supporting its right under specific circumstances yet expressing concerns over potential abuses and the ethical responsibility of physicians to preserve life. Euthanasia Medical Students Nigeria Introduction Euthanasia remains a highly debated topic globally, given its ethical, legal, and moral implications. It refers to the intentional act of ending a person's life to alleviate unbearable suffering by a medical professional.( 1 ) Euthanasia can be classified into various types: active or passive, voluntary, involuntary, non-voluntary, and assisted. Active euthanasia involves deliberately taking steps to end a patient's life, whereas passive euthanasia is the withholding or withdrawal of treatments necessary to sustain life.( 2 ) Voluntary euthanasia occurs with the informed consent of a competent individual, while involuntary euthanasia is done without consent.( 1 ) In cases of non-voluntary euthanasia, a third party makes decisions on behalf of a person who is unable to consent. Assisted euthanasia, on the other hand, involves providing the means for a suffering person to end their own life.( 3 ) In recent years, euthanasia has become a growing concept in palliative care, which is a crucial aspect of end-of-life care, addressing the needs of terminally ill patients. A substantial number of people with terminal illnesses and intractable suffering need palliative care, with the majority living in middle- and low-income countries.( 4 ) However, only 14% of the global population who require palliative care access it, most of whom are in European countries.( 5 ) This burden occurs partly due to limited knowledge of the principles of end-of-life care among healthcare workers.( 6 ) As future healthcare professionals, medical students will play a key role in delivering palliative care and shaping policies related to end-of-life care. Their evolving views on euthanasia may influence future legislation and practices, even as their beliefs are likely to shift throughout their careers. The legality of euthanasia varies significantly worldwide, reflecting societal, cultural, and religious beliefs. While many countries maintain strict prohibitions against euthanasia due to ethical concerns and the potential for misuse, it has become increasingly acceptable in some developed nations. Countries like the Netherlands, Belgium, Canada, Colombia, and Luxembourg have fully legalized euthanasia, while others, such as Switzerland, Germany, and several U.S. states (e.g., Oregon, Washington, California, and Vermont), permit it under specific conditions.( 3 ) However, euthanasia remains illegal in all African countries, where no laws support either euthanasia or physician-assisted suicide.( 7 ) Africa's legal and cultural environment remains conservative, with widespread opposition to the practice.( 7 ) The ethical debate surrounding euthanasia hinges on several key principles. Autonomy advocates for individuals' right to make decisions about their bodies and lives, including the choice of how and when to die, particularly in cases of extreme suffering.( 8 ) Beneficence and non-maleficence emphasize the duty of healthcare providers to alleviate suffering and avoid harm.( 8 ) However, these principles might seem at odds with the sanctity of life, which holds that life has intrinsic value and should always be preserved, and professional integrity, which calls on healthcare professionals to uphold ethical standards and societal trust.( 8 ) Concerns about the potential for abuse and the normalization of suicide also contribute to the complex ethical landscape surrounding euthanasia. International studies reveal that medical students hold mixed views on euthanasia. For instance, a study in New Zealand found that clinical students were less likely to support euthanasia compared to non-clinical students.( 9 ) Similarly, a study in Hong Kong reported that more than half of the 6th-year medical students did not support euthanasia.( 10 ) In contrast, a systematic review consisting of 12 selected articles, conducted over the last decade, reported a predominantly positive view of euthanasia. The most common reasons cited for support were autonomy and relief of suffering. However, it highlighted religious and personal beliefs, and the risk of abuse as key arguments against euthanasia. ( 11 ) In a study by Wojciech Leppert et al., 588 medical students at two Polish universities were surveyed, with the majority expressing a positive attitude toward euthanasia. However, 81.8% of respondents also expressed concerns about the potential for abuse.( 12 ) Additionally, a study in South Africa showed that more than half of the respondents were willing to legalize euthanasia.( 13 ) Despite the global conversation on euthanasia, there is a lack of research on medical students' perspectives in Nigeria. As medical education evolves globally, it continuously incorporates ethical deliberations such as patient autonomy, quality of life, and palliative care, students are encouraged to view euthanasia as a potential option under specific circumstances.( 14 ) Understanding their views could help identify gaps in medical training and better prepare future healthcare professionals for the ethical dilemmas they may face. This study aims to explore the attitudes of medical students in Nigeria toward euthanasia, shedding light on their readiness to engage in these complex discussions and inform future healthcare policy. Methodology Study Setting The study was conducted at University of Calabar Teaching Hospital (UCTH) which is located in South-South region of Nigeria. It is a tertiary healthcare centre that also provides medical training to medical students. Study design A descriptive cross-sectional study design was used to assess the perspective of euthanasia among 126 clinical students at the University of Calabar, Nigeria. Eligibility Criteria Inclusion Criteria Fourth- and fifth-year medical students, currently enrolled in University of Calabar. Exclusion Criteria Non-consenting medical students. Sampling Simple random sampling, deploying a random number generator, was used, with a serially numbered class list as the sample frame. Fourth- and fifth-year medical students were recruited. Final-year students were excluded due to unavailability as they engaged in rural clinical postings during data collection. Sample size of 126 was gotten using the Taro-Yamane formular. n = N/1 + N (e) 2 Where n = the minimum sample size. N = the total population = 547 e = precision of sampling error = 5% Questionnaire A semi-structured questionnaire was adapted from a previous study and contained participants’ socio-demographic information (age, class, and gender) and the euthanasia attitude scale.( 15 ) The scale developed by Tordella and Neutens in 1996 was used to assess individuals’ attitudes towards euthanasia. It contained twenty-one questions, classified into four groups: naturalistic belief, ethical considerations, practical considerations, and treasuring life. Response format uses a Likert scale; items were ranked from 1 to 5, with 1 indicating strong opposition to euthanasia, 3 indicating neutral, and 5 indicating strong support for euthanasia. Data collection and analysis Data was collected using self-administered questionnaires. The questionnaires were administered, and statistical analysis was done with IBM SPSS version 26. The comparison between groups was performed using ANOVA, independent T test and Games-Howell post hoc test. Ethical consideration Ethical approval for this study was sought and obtained from the Health Research Ethics Committee of Federal Neuropsychiatric Hospital, Calabar. Written informed consent was obtained through individual questionnaires. Participants were informed about the study’s purpose, anonymity, and their rights to consent and withdraw from the study at any time should they have a reason or need to. Only consenting participants were included in the study. Results Sociodemographic Data The study population consisted of 121 medical students, with a majority (54.5%) being females. The mean age was 23.9%, with a standard deviation of 2. The participants’ age range was 20–35, with the highest proportion (69.7%) between 20 and 24. Regarding the academic level, 61 (50.4%) were in their fourth year, and 60 (49.6%) were in their fifth year. Table 1 Sociodemographic characteristics of medical students’ perspectives towards euthanasia in the University of Calabar, n = 121 Variable Frequency (n = 121) Percentage (%) Age group (years) < 24 50 45.9 24–30 73 47.8 31–35 4 6.3 Mean age ± SD 23.97 ± 2.754 Gender Male 54 44.6 Female 66 54.5 Academic year Year 4 61 50.4 Year 5 60 49.6 Table 2 Medical students’ responses to the Euthanasia Attitude Scale at the University of Calabar, October 2024, n = 121 Agree Neutral Disagree Ethical consideration 1 - A person with a terminal illness has the right to decide to die. 83(68.6%) 21 (17.4%) 17 (14.1%) 2 - Influencing death for merciful reasons is wrong. 36 (29.7%) 41 (33.9%) 44 (36.4%) 3 - Euthanasia should be accepted in today’s society. 68 (56.2%) 21 (17.4%) 32 (26.4%) 4 - There are never cases when euthanasia is appropriate. 25 (20.6%) 21 (17.4&) 75 (62.0%) 5 - Euthanasia is helpful at the right time and place (under the right circumstances) 79 (65.2%) 17 (14.0%) 25 (20.6%) 6 - Euthanasia is a human act 61(50.4%) 36 (29.8%) 24 (19.8%) 7 -Euthanasia should be used when a person has terminal illness. 31 (25.6%) 32 (26.4%) 58 (48.0%) 8 - The taking of human life is wrong no matter what the circumstances. 43 (35.5%) 32 (26.4%) 46 (38.0%) 9 - Euthanasia is acceptable in cases when all hope of recovery is gone. 65(53.7%) 25 (20.7%) 31 (25.6%) Practical consideration 1 - Euthanasia should be acceptable if the person is old. 23 (19.0%) 46 (38.0%) 52(42.9%) 2 - If a terminally ill or injured person is increasingly concerned about the burden that his/her deterioration of health has placed on his/her family, I will support his/her request for euthanasia. 61 (50.4%) 26 (21.5%) 34 (28.1%) 3 - Euthanasia will lead to abuse. 70 (57.8%) 29 (24.0%) 22 (18.2%) Treasuring life 1 -There are very few cases when euthanasia is acceptable. 78(64.5%) 20 (16.5%) 23 (18.0%) 2 - Euthanasia should be practiced only to eliminate physical pain and not emotional pain. 47 (38.8%) 38 (31.4%) 36(29.8%) 3 -One’s job is to sustain and preserve life, not to end it. 82 (67.8%) 29 (24.0%) 10 (8.4%) 4 -One of the key professional ethics of physicians is to prolong lives, not to end lives. 94 (77.7%) 19 (15.7%) 8 (6.6%) Naturalistic belief 1. A person should not be kept alive by a machine. 8 (6.6%) 34 (28.1%) 79 (65.3%) 2. Natural death is a cure for suffering. 39 (32.2%) 50 (40.3%) 32 (26.4%) Ethical consideration The ethical consideration section focused on respect for autonomy, sanctity, and quality of life, with 33.9% of respondents undecided about the morality of influencing death through mercy and 68.6% believing that a patient with a terminal illness has the right to choose to die. On the other hand, 35.5% think that euthanasia is never appropriate. Meanwhile, 56.2% of participants agreed that euthanasia should be accepted in modern society, and 65.2% agreed that it is beneficial at the right time and place under the right conditions. In cases where there is no hope of recovery, 53.7% agree that euthanasia is acceptable. Practical consideration This section assessed medical student’s individual, thoughtful, and rational evaluation of euthanasia 42.9% of participants believed that euthanasia should not be justified solely based on old age. Additionally, 50.4% would support euthanasia in cases where the patient is distressed about the strain their ill health places on their family. Moreover, 57.8% were concerned that legalizing euthanasia could lead to abuse. Treasuring life This section evaluated respondent’s value for human life and their significance to preserving it. About 64.5% of participants agreed that there are few instances where euthanasia would be appropriate. While 31.8% were unsure, 38.8% favored euthanasia only in cases of severe physical pain, not emotional suffering. In addition, 67.8% believed that one’s job is to preserve life, not end it similarly to save lives rather than end one is a major professional ethic, according to 77.7% of respondents. Naturalistic beliefs The naturalistic beliefs section assessed the participants’ perceptions of life sustenance in comatose and diseased states. 50.4% disagreed with no life sustenance by machines, and 28.1% were neutral. Most participants were neutral (41.3%) when asked to choose whether natural death is a cure for suffering; 25.6% agreed, while 19.8% disagreed. Table 3 Correlation of Age and Gender with Medical Students’ Perspectives Towards Euthanasia in the University of Calabar, n = 121 Group Ethical Consideration (Mean ± SD) Practical Consideration (Mean ± SD) Treasuring Life (Mean ± SD) Naturalistic Belief (Mean ± SD) Age (< 25) 29.81 ± 7.24 8.42 ± 2.28 9.33 ± 2.44 5.22 ± 1.20 Age (≥ 25) 29.73 ± 8.24 8.06 ± 2.38 8.91 ± 2.35 5.27 ± 1.10 t-statistic (p-value) 0.052 (0.959) 0.763 (0.447) 0.853 (0.395) -0.238 (0.813) Male 29.11 ± 8.27 8.37 ± 2.49 9.15 ± 2.66 5.26 ± 1.12 Female 30.35 ± 6.86 8.29 ± 2.18 9.29 ± 2.22 5.20 ± 1.22 t-statistic (p-value) -0.896 (0.372) 0.193 (0.847) -0.313 (0.754) 0.289 (0.773) Table 3 Attitude Towards Euthanasia Across Different Academic Levels of Medical students’ perspectives towards euthanasia in the University of Calabar, n = 121 Variable C1B Mean (SD) C1A Mean (SD) C2B Mean (SD) C2A Mean (SD) C3 Mean (SD) ANOVA F (p-value) Post Hoc (Significant Pair) Ethical Consideration Scores 28.05 (7.91) 27.42 (8.83) 33.32 (5.27) 31.77 (6.27) 29.56 (7.09) 2.815 (0.028) C2B > C1B (p = 0.019) Practical Consideration Scores 8.17 (2.31) 7.79 (2.57) 8.68 (2.06) 8.36 (2.26) 8.81 (2.48) 0.609 (0.657) None Treasuring Life Scores 8.45 (2.16) 9.26 (2.33) 9.91 (2.31) 10.05 (2.40) 9.06 (2.91) 2.266 (0.066) None Naturalistic Belief Scores 5.02 (1.14) 5.37 (1.07) 5.32 (1.09) 5.36 (1.22) 5.31 (1.45) 0.509 (0.729) None From Table 3 , across the classes (C1B, C1A, C2B, C2A, and C3), a one-way ANOVA revealed a statistically significant difference in ethical consideration scores ( F (4, N) = 2.815, p = 0.028). Post hoc analysis indicated that participants in C2B scored significantly higher than those in C1B ( p = 0.01, suggesting improved ethical considerations in the C2B class. There were no statistically significant differences in practical consideration scores ( F = 0.609, p = 0.657), treasuring life scores ( F = 2.266, p = 0.06), or naturalistic belief scores ( F = 0.509, p = 0.729). While treasuring life scores showed a trend toward higher values in the C2A group, this was not statistically significant. Discussion Our findings show that University of Calabar medical students hold a nuanced view towards euthanasia. The majority support the legislation of euthanasia under specific circumstances, yet express concerns over potential abuse and the ethical responsibility of physicians to preserve life. While over 50% agreed that euthanasia should be accepted in today’s society, and expressed a strong belief that a physician’s core medical duty is to preserve life. In comparison, more than half of the respondents support euthanasia in cases where a patient is distressed by the burden their illness places on their family. In comparison, 46.3% of participants agreed to perform euthanasia if it were legal. Furthermore, we observed that respondents were concerned that legalizing euthanasia could open the door to the mistreatment of vulnerable patients and potential cases of misuse by unethical practitioners. Additionally, our findings show that the level of medical education is significantly associated with students’ attitudes towards euthanasia, particularly concerning ethical considerations. In recent years, multiple studies measuring medical students’ attitudes toward euthanasia have reported similar findings. For instance, research conducted among third- to fifth-year medical students at Stellenbosch University, South Africa, showed that most participants believed the practices of euthanasia/PAS should be legalized in South Africa. Another study among final-year medical students at Khartoum University contradicted our findings, reporting that the majority (76.6%) opposed euthanasia due to ethical considerations, religious beliefs, and fear of misuse. ( 16 ) Similar findings regarding religious beliefs were also recorded among medical students in Hong Kong and New Zealand.( 9 , 10 ) Religious medical students may oppose euthanasia because the practice often conflicts with their faith-based beliefs. A central argument for euthanasia is the principle of respecting the patient’s autonomy. Our study observed a fairly positive perspective of euthanasia under ethical consideration primarily due to the respondents’ firm belief in autonomy, implying that they believe in patients’ right to decide what they consider proper care. However, for many, the principles of beneficence and non-maleficence remain firm, even in the face of complex and emotionally charged end-of-life decisions. Over two-thirds of our respondents agree that a physician must prolong and not end life, and the idea of ending a patient’s life is a violation of their commitment to care and heal, rather than to harm. The ethical principles of beneficence and non-maleficence guide medical professionals to act in the best interests of their patients and avoid causing harm. This study highlights that these values pose significant barriers to the acceptance of euthanasia among medical students. Most respondents have a good attitude towards euthanasia regarding intractable suffering and impossible recovery, which is consistent with a previous study in Brazil.( 17 ) This concern supports the argument that euthanasia could be a compassionate response to intractable suffering. Some participants believe that the right to euthanasia and assisted suicide for terminally ill patients with no hope of recovery does not conflict with the right to life. If patients, healthcare providers, and society believe that the only way to alleviate suffering is through death, giving the patient the option of euthanasia could be viewed as allowing the patient to die with dignity. This perspective may shed light on why most of our participants supported the acceptance of euthanasia in our society. Another primary concern emerging is the fear that euthanasia could lead to abuse. More than half of the respondents worry that legalizing euthanasia could open the door to the mistreatment of vulnerable patients, particularly those who might be pressured by family or society to end their lives prematurely. Minors, the elderly, and people with psychiatric disorders are highly vulnerable to this pressure. Similar findings were seen in a study that compared medical students from different countries, views towards euthanasia.( 18 ) Most respondents agreed that euthanasia poses a risk of abuse, underscoring the need for stringent safeguards if it were ever to be legalized. More than two-thirds (80.1%) of participants stated that they would prefer a dedicated ethics committee to decide who receives euthanasia/PAS. These concerns are not easily dismissed and point to a critical challenge: how to protect vulnerable individuals while also considering the suffering of patients who might desire euthanasia as a means of ending their pain. Additionally, we observed a more favourable view of euthanasia among Fifth-year medical students compared to their fourth-year counterparts. This difference in perspective may be attributed to their increased exposure to various medical experiences and departments. However, our findings do not align with previous studies in New Zealand and Brazil, which reported a more negative attitude toward euthanasia among senior medical students compared to their younger peers.( 9 , 17 ) Currently, multi-center studies across various regions are needed to better understand medical students’ perspectives towards euthanasia in Nigeria. Significant changes should be made in the medical curriculum by introducing medical ethics early, allowing students to explore the moral, cultural, and personal implications of euthanasia. Case studies and simulations can expose students to the emotional and intellectual complexities they may face in real-life situations. These exercises should include scenarios that explore religious, cultural, and economic factors influencing end-of-life decisions. Limitations Given the moral, religious, and social sensitivity of euthanasia, the use of a self-reported survey may have introduced social desirability bias, with participants providing answers that they deem as more socially acceptable. Additionally, medical students’ attitude towards euthanasia may shift over time, due to increased clinical exposure and personal experience, highlighting a major limitation in cross-sectional studies. Conclusion This study explores medical student’s attitudes toward euthanasia in Nigeria. They hold a nuanced view towards euthanasia, broadly supporting its right under specific circumstances yet expressing concerns over potential abuse and the ethical responsibility of physicians to preserve life. The tension between alleviating suffering and preventing harm is at the core of the euthanasia debate. While some participants recognized that there might be cases where euthanasia could be justified, the overwhelming concern about its potential for abuse and the erosion of trust in healthcare systems suggests that many believe it is better to err on the side of caution. Medical students must be aware of the different arguments on euthanasia to enable better decision-making as future doctors. Declarations Conflict of Interest Statement and Funding The authors have no funding, financial relationships or conflicts of interest to disclose. Authors Contributions EAE: made substantial contribution to the conceptualization, writing, data analysis and reviewing of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work. PMW: made substantial contribution to the writing, data collection, and reviewing of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work. CCU: made substantial contribution to the writing, data collection and reviewing of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work. BMU: made substantial contribution to the writing, and reviewing, of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work. ACO: made substantial contribution to the writing, data collection and reviewing of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work. IBA: made substantial contribution to data collection and analysis of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work. EIA: made substantial contribution to the writing of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work. EUS: made substantial contribution to the writing of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work. Data Availability Data is provided within the manuscript. References Khan YB, Abukhait RO, Fatma Abdulwahab Dehlab. Contemplating the controversy: Exploring the Ethics and Realities of Euthanasia. Int J Sci Res Arch. 2024;11(2):2058–66. Euthanasia -. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6749981","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":475603563,"identity":"c36af032-f4e7-4e8b-833e-ed10354ec8db","order_by":0,"name":"Emmanuel Aniekan Essien","email":"","orcid":"","institution":"Federal Neuropsychiatry Hospital, Calabar, Nigeria.","correspondingAuthor":false,"prefix":"","firstName":"Emmanuel","middleName":"Aniekan","lastName":"Essien","suffix":""},{"id":475603564,"identity":"1c6d0f18-03ed-4b5f-a677-80d3f5322427","order_by":1,"name":"Precious Miracle Wagwula","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAz0lEQVRIiWNgGAWjYDADfhCRUECKFskGkBYDUrQYHACTRKiUb+9O/MxTU2tvfH514ocHBgzy/GIH8Gth7Dm7WZrn2HFmsxtvN0sAHWY4c3YCfi3MErkbpHPYjrGZ3Ti7AaQlweA2AS1s8m83/875d4zHeMbZzT+I0sIjwbtNOretRsKAv3cbcbZI8ORus/7bd8BA4gbvNosEAwnCfpFvP7v55oxvdfb8/UDGjwobeX5pAlqg4DDQPrBKCaKUg0AdMMUcIFr1KBgFo2AUjDAAAGp0QxXOxOFpAAAAAElFTkSuQmCC","orcid":"","institution":"University of Calabar Medical Students’ Research Hub","correspondingAuthor":true,"prefix":"","firstName":"Precious","middleName":"Miracle","lastName":"Wagwula","suffix":""},{"id":475603565,"identity":"6d242d73-259e-456b-a3ac-6df3918f930a","order_by":2,"name":"Chelsea Chioma Ukanwoke","email":"","orcid":"","institution":"University of Calabar Medical Students’ Research Hub","correspondingAuthor":false,"prefix":"","firstName":"Chelsea","middleName":"Chioma","lastName":"Ukanwoke","suffix":""},{"id":475603566,"identity":"89d2f454-ccdb-4b5e-b688-0039095c65b8","order_by":3,"name":"Bonaventure Michael Ukoaka","email":"","orcid":"","institution":"Community and Clinical Research Division, First On-Call Initiative, Port-Harcourt, Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Bonaventure","middleName":"Michael","lastName":"Ukoaka","suffix":""},{"id":475603567,"identity":"927492ac-5028-425b-b4a3-f2f241e1138e","order_by":4,"name":"Athanasius Christopher Ofem","email":"","orcid":"","institution":"University of Calabar Medical Students’ Research Hub","correspondingAuthor":false,"prefix":"","firstName":"Athanasius","middleName":"Christopher","lastName":"Ofem","suffix":""},{"id":475603568,"identity":"dae497a0-f446-47ed-821d-45d6e5364dd0","order_by":5,"name":"Isaac Brown Ado","email":"","orcid":"","institution":"University of Calabar Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Isaac","middleName":"Brown","lastName":"Ado","suffix":""},{"id":475603569,"identity":"a3a41c1d-17ae-4101-a7c9-c1b3589c495e","order_by":6,"name":"Evans-Chris Izuchukwu Abiaka","email":"","orcid":"","institution":"University of Calabar Medical Students’ Research Hub","correspondingAuthor":false,"prefix":"","firstName":"Evans-Chris","middleName":"Izuchukwu","lastName":"Abiaka","suffix":""},{"id":475603570,"identity":"1b0ec54c-cca4-4e5e-b2bf-5b2683c28123","order_by":7,"name":"Edifon Udeme Silas","email":"","orcid":"","institution":"University of Calabar Medical Students’ Research Hub","correspondingAuthor":false,"prefix":"","firstName":"Edifon","middleName":"Udeme","lastName":"Silas","suffix":""}],"badges":[],"createdAt":"2025-05-26 10:53:04","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6749981/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6749981/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85470607,"identity":"bfcc0dac-fd5d-4ee6-a49c-9dc58c76be82","added_by":"auto","created_at":"2025-06-26 09:08:53","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":910970,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6749981/v1/9e6162e3-862f-4652-8424-e7b74a1148bd.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eMedical Students’ Perspective on Euthanasia in Calabar, Nigeria: A Cross-Sectional Study\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eEuthanasia remains a highly debated topic globally, given its ethical, legal, and moral implications. It refers to the intentional act of ending a person's life to alleviate unbearable suffering by a medical professional.(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) Euthanasia can be classified into various types: active or passive, voluntary, involuntary, non-voluntary, and assisted. Active euthanasia involves deliberately taking steps to end a patient's life, whereas passive euthanasia is the withholding or withdrawal of treatments necessary to sustain life.(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) Voluntary euthanasia occurs with the informed consent of a competent individual, while involuntary euthanasia is done without consent.(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) In cases of non-voluntary euthanasia, a third party makes decisions on behalf of a person who is unable to consent. Assisted euthanasia, on the other hand, involves providing the means for a suffering person to end their own life.(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eIn recent years, euthanasia has become a growing concept in palliative care, which is a crucial aspect of end-of-life care, addressing the needs of terminally ill patients. A substantial number of people with terminal illnesses and intractable suffering need palliative care, with the majority living in middle- and low-income countries.(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) However, only 14% of the global population who require palliative care access it, most of whom are in European countries.(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) This burden occurs partly due to limited knowledge of the principles of end-of-life care among healthcare workers.(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) As future healthcare professionals, medical students will play a key role in delivering palliative care and shaping policies related to end-of-life care. Their evolving views on euthanasia may influence future legislation and practices, even as their beliefs are likely to shift throughout their careers.\u003c/p\u003e \u003cp\u003eThe legality of euthanasia varies significantly worldwide, reflecting societal, cultural, and religious beliefs. While many countries maintain strict prohibitions against euthanasia due to ethical concerns and the potential for misuse, it has become increasingly acceptable in some developed nations. Countries like the Netherlands, Belgium, Canada, Colombia, and Luxembourg have fully legalized euthanasia, while others, such as Switzerland, Germany, and several U.S. states (e.g., Oregon, Washington, California, and Vermont), permit it under specific conditions.(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) However, euthanasia remains illegal in all African countries, where no laws support either euthanasia or physician-assisted suicide.(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) Africa's legal and cultural environment remains conservative, with widespread opposition to the practice.(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e The ethical debate surrounding euthanasia hinges on several key principles. Autonomy advocates for individuals' right to make decisions about their bodies and lives, including the choice of how and when to die, particularly in cases of extreme suffering.(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) Beneficence and non-maleficence emphasize the duty of healthcare providers to alleviate suffering and avoid harm.(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) However, these principles might seem at odds with the sanctity of life, which holds that life has intrinsic value and should always be preserved, and professional integrity, which calls on healthcare professionals to uphold ethical standards and societal trust.(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) Concerns about the potential for abuse and the normalization of suicide also contribute to the complex ethical landscape surrounding euthanasia.\u003c/p\u003e \u003cp\u003eInternational studies reveal that medical students hold mixed views on euthanasia. For instance, a study in New Zealand found that clinical students were less likely to support euthanasia compared to non-clinical students.(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) Similarly, a study in Hong Kong reported that more than half of the 6th-year medical students did not support euthanasia.(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) In contrast, a systematic review consisting of 12 selected articles, conducted over the last decade, reported a predominantly positive view of euthanasia. The most common reasons cited for support were autonomy and relief of suffering. However, it highlighted religious and personal beliefs, and the risk of abuse as key arguments against euthanasia. (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) In a study by Wojciech Leppert et al., 588 medical students at two Polish universities were surveyed, with the majority expressing a positive attitude toward euthanasia. However, 81.8% of respondents also expressed concerns about the potential for abuse.(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) Additionally, a study in South Africa showed that more than half of the respondents were willing to legalize euthanasia.(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eDespite the global conversation on euthanasia, there is a lack of research on medical students' perspectives in Nigeria. As medical education evolves globally, it continuously incorporates ethical deliberations such as patient autonomy, quality of life, and palliative care, students are encouraged to view euthanasia as a potential option under specific circumstances.(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) Understanding their views could help identify gaps in medical training and better prepare future healthcare professionals for the ethical dilemmas they may face. This study aims to explore the attitudes of medical students in Nigeria toward euthanasia, shedding light on their readiness to engage in these complex discussions and inform future healthcare policy.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Setting\u003c/h2\u003e \u003cp\u003eThe study was conducted at University of Calabar Teaching Hospital (UCTH) which is located in South-South region of Nigeria. It is a tertiary healthcare centre that also provides medical training to medical students.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy design\u003c/h3\u003e\n\u003cp\u003eA descriptive cross-sectional study design was used to assess the perspective of euthanasia among 126 clinical students at the University of Calabar, Nigeria.\u003c/p\u003e\n\u003ch3\u003eEligibility Criteria\u003c/h3\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eInclusion Criteria\u003c/h2\u003e \u003cp\u003eFourth- and fifth-year medical students, currently enrolled in University of Calabar.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eExclusion Criteria\u003c/h3\u003e\n\u003cp\u003eNon-consenting medical students.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eSampling\u003c/h2\u003e \u003cp\u003eSimple random sampling, deploying a random number generator, was used, with a serially numbered class list as the sample frame. Fourth- and fifth-year medical students were recruited. Final-year students were excluded due to unavailability as they engaged in rural clinical postings during data collection.\u003c/p\u003e \u003cp\u003eSample size of 126 was gotten using the Taro-Yamane formular.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;N/1\u0026thinsp;+\u0026thinsp;N (e) 2\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eWhere\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;the minimum sample size.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;the total population\u0026thinsp;=\u0026thinsp;547\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ee\u0026thinsp;=\u0026thinsp;precision of sampling error\u0026thinsp;=\u0026thinsp;5%\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eQuestionnaire\u003c/h3\u003e\n\u003cp\u003eA semi-structured questionnaire was adapted from a previous study and contained participants\u0026rsquo; socio-demographic information (age, class, and gender) and the euthanasia attitude scale.(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) The scale developed by Tordella and Neutens in 1996 was used to assess individuals\u0026rsquo; attitudes towards euthanasia. It contained twenty-one questions, classified into four groups: naturalistic belief, ethical considerations, practical considerations, and treasuring life. Response format uses a Likert scale; items were ranked from 1 to 5, with 1 indicating strong opposition to euthanasia, 3 indicating neutral, and 5 indicating strong support for euthanasia.\u003c/p\u003e\n\u003ch3\u003eData collection and analysis\u003c/h3\u003e\n\u003cp\u003eData was collected using self-administered questionnaires. The questionnaires were administered, and statistical analysis was done with IBM SPSS version 26. The comparison between groups was performed using ANOVA, independent T test and Games-Howell post hoc test.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eEthical consideration\u003c/h2\u003e \u003cp\u003eEthical approval for this study was sought and obtained from the Health Research Ethics Committee of Federal Neuropsychiatric Hospital, Calabar. Written informed consent was obtained through individual questionnaires. Participants were informed about the study\u0026rsquo;s purpose, anonymity, and their rights to consent and withdraw from the study at any time should they have a reason or need to. Only consenting participants were included in the study.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eSociodemographic Data\u003c/h2\u003e \u003cp\u003eThe study population consisted of 121 medical students, with a majority (54.5%) being females. The mean age was 23.9%, with a standard deviation of 2. The participants\u0026rsquo; age range was 20\u0026ndash;35, with the highest proportion (69.7%) between 20 and 24. Regarding the academic level, 61 (50.4%) were in their fourth year, and 60 (49.6%) were in their fifth year.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic characteristics of medical students\u0026rsquo; perspectives towards euthanasia in the University of Calabar, n\u0026thinsp;=\u0026thinsp;121\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n\u0026thinsp;=\u0026thinsp;121)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group (years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e24\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31\u0026ndash;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMean age\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e23.97\u0026thinsp;\u0026plusmn;\u0026thinsp;2.754\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAcademic year\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYear 4\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYear 5\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMedical students\u0026rsquo; responses to the Euthanasia Attitude Scale at the University of Calabar, October 2024, n\u0026thinsp;=\u0026thinsp;121\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEthical consideration\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 - A person with a terminal illness has the right to decide to die.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83(68.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (17.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17 (14.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2 - Influencing death for merciful reasons is wrong.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36 (29.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41 (33.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44 (36.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3 - Euthanasia should be accepted in today\u0026rsquo;s society.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68 (56.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (17.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32 (26.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 - There are never cases when euthanasia is appropriate.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25 (20.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (17.4\u0026amp;)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e75 (62.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5 - Euthanasia is helpful at the right time and place (under the right\u003c/p\u003e \u003cp\u003ecircumstances)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79 (65.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17 (14.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25 (20.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6 - Euthanasia is a human act\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e61(50.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (29.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24 (19.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7 -Euthanasia should be used when a person has terminal illness.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31 (25.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32 (26.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58 (48.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 - The taking of human life is wrong no matter what the circumstances.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43 (35.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32 (26.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e46 (38.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9 - Euthanasia is acceptable in cases when all hope of recovery is gone.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e65(53.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25 (20.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31 (25.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePractical consideration\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 - Euthanasia should be acceptable if the person is old.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23 (19.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46 (38.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52(42.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2 - If a terminally ill or injured person is increasingly concerned\u003c/p\u003e \u003cp\u003eabout the burden that his/her deterioration of health has placed on\u003c/p\u003e \u003cp\u003ehis/her family, I will support his/her request for euthanasia.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e61 (50.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (21.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34 (28.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3 - Euthanasia will lead to abuse.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70 (57.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29 (24.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22 (18.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTreasuring life\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 -There are very few cases when euthanasia is acceptable.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e78(64.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20 (16.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23 (18.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2 - Euthanasia should be practiced only to eliminate physical pain and not emotional pain.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47 (38.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38 (31.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36(29.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3 -One\u0026rsquo;s job is to sustain and preserve life, not to end it.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e82 (67.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29 (24.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (8.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 -One of the key professional ethics of physicians is to prolong lives, not to end lives.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e94 (77.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (15.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (6.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNaturalistic belief\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. A person should not be kept alive by a machine.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (6.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34 (28.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e79 (65.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. Natural death is a cure for suffering.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e39 (32.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50 (40.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32 (26.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eEthical consideration\u003c/h2\u003e \u003cp\u003eThe ethical consideration section focused on respect for autonomy, sanctity, and quality of life, with 33.9% of respondents undecided about the morality of influencing death through mercy and 68.6% believing that a patient with a terminal illness has the right to choose to die. On the other hand, 35.5% think that euthanasia is never appropriate. Meanwhile, 56.2% of participants agreed that euthanasia should be accepted in modern society, and 65.2% agreed that it is beneficial at the right time and place under the right conditions. In cases where there is no hope of recovery, 53.7% agree that euthanasia is acceptable.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003ePractical consideration\u003c/h2\u003e \u003cp\u003eThis section assessed medical student\u0026rsquo;s individual, thoughtful, and rational evaluation of euthanasia 42.9% of participants believed that euthanasia should not be justified solely based on old age. Additionally, 50.4% would support euthanasia in cases where the patient is distressed about the strain their ill health places on their family. Moreover, 57.8% were concerned that legalizing euthanasia could lead to abuse.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eTreasuring life\u003c/h2\u003e \u003cp\u003eThis section evaluated respondent\u0026rsquo;s value for human life and their significance to preserving it. About 64.5% of participants agreed that there are few instances where euthanasia would be appropriate. While 31.8% were unsure, 38.8% favored euthanasia only in cases of severe physical pain, not emotional suffering. In addition, 67.8% believed that one\u0026rsquo;s job is to preserve life, not end it similarly to save lives rather than end one is a major professional ethic, according to 77.7% of respondents.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eNaturalistic beliefs\u003c/h2\u003e \u003cp\u003eThe naturalistic beliefs section assessed the participants\u0026rsquo; perceptions of life sustenance in comatose and diseased states. 50.4% disagreed with no life sustenance by machines, and 28.1% were neutral. Most participants were neutral (41.3%) when asked to choose whether natural death is a cure for suffering; 25.6% agreed, while 19.8% disagreed.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation of Age and Gender with Medical Students\u0026rsquo; Perspectives Towards Euthanasia in the University of Calabar, n\u0026thinsp;=\u0026thinsp;121\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEthical Consideration (Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePractical Consideration (Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTreasuring Life (Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNaturalistic Belief (Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (\u0026lt;\u0026thinsp;25)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29.81\u0026thinsp;\u0026plusmn;\u0026thinsp;7.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.42\u0026thinsp;\u0026plusmn;\u0026thinsp;2.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.33\u0026thinsp;\u0026plusmn;\u0026thinsp;2.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (\u0026ge;\u0026thinsp;25)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29.73\u0026thinsp;\u0026plusmn;\u0026thinsp;8.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.06\u0026thinsp;\u0026plusmn;\u0026thinsp;2.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.91\u0026thinsp;\u0026plusmn;\u0026thinsp;2.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.27\u0026thinsp;\u0026plusmn;\u0026thinsp;1.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003et-statistic (p-value)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.052 (0.959)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.763 (0.447)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.853 (0.395)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.238 (0.813)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29.11\u0026thinsp;\u0026plusmn;\u0026thinsp;8.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.37\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.15\u0026thinsp;\u0026plusmn;\u0026thinsp;2.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.26\u0026thinsp;\u0026plusmn;\u0026thinsp;1.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFemale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30.35\u0026thinsp;\u0026plusmn;\u0026thinsp;6.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.29\u0026thinsp;\u0026plusmn;\u0026thinsp;2.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.29\u0026thinsp;\u0026plusmn;\u0026thinsp;2.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.20\u0026thinsp;\u0026plusmn;\u0026thinsp;1.22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003et-statistic (p-value)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.896 (0.372)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.193 (0.847)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.313 (0.754)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.289 (0.773)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAttitude Towards Euthanasia Across Different Academic Levels of Medical students\u0026rsquo; perspectives towards euthanasia in the University of Calabar, n\u0026thinsp;=\u0026thinsp;121\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eC1B Mean (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eC1A Mean (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eC2B Mean (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eC2A Mean (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eC3 Mean (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eANOVA F (p-value)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ePost Hoc (Significant Pair)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEthical Consideration Scores\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28.05 (7.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.42 (8.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.32 (5.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e31.77 (6.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e29.56 (7.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.815 (0.028)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003eC2B\u0026thinsp;\u0026gt;\u0026thinsp;C1B (p\u0026thinsp;=\u0026thinsp;0.019)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePractical Consideration Scores\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.17 (2.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.79 (2.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.68 (2.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8.36 (2.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e8.81 (2.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.609 (0.657)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTreasuring Life Scores\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.45 (2.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.26 (2.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.91 (2.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10.05 (2.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e9.06 (2.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.266 (0.066)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNaturalistic Belief Scores\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.02 (1.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.37 (1.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.32 (1.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5.36 (1.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5.31 (1.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.509 (0.729)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFrom Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003e, across the classes (C1B, C1A, C2B, C2A, and C3), a one-way ANOVA revealed a statistically significant difference in ethical consideration scores (\u003cem\u003eF\u003c/em\u003e(4, N)\u0026thinsp;=\u0026thinsp;2.815, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.028). Post hoc analysis indicated that participants in C2B scored significantly higher than those in C1B (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.01, suggesting improved ethical considerations in the C2B class. There were no statistically significant differences in practical consideration scores (\u003cem\u003eF\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.609, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.657), treasuring life scores (\u003cem\u003eF\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.266, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.06), or naturalistic belief scores (\u003cem\u003eF\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.509, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.729). While treasuring life scores showed a trend toward higher values in the C2A group, this was not statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur findings show that University of Calabar medical students hold a nuanced view towards euthanasia. The majority support the legislation of euthanasia under specific circumstances, yet express concerns over potential abuse and the ethical responsibility of physicians to preserve life. While over 50% agreed that euthanasia should be accepted in today\u0026rsquo;s society, and expressed a strong belief that a physician\u0026rsquo;s core medical duty is to preserve life. In comparison, more than half of the respondents support euthanasia in cases where a patient is distressed by the burden their illness places on their family. In comparison, 46.3% of participants agreed to perform euthanasia if it were legal. Furthermore, we observed that respondents were concerned that legalizing euthanasia could open the door to the mistreatment of vulnerable patients and potential cases of misuse by unethical practitioners. Additionally, our findings show that the level of medical education is significantly associated with students\u0026rsquo; attitudes towards euthanasia, particularly concerning ethical considerations.\u003c/p\u003e \u003cp\u003eIn recent years, multiple studies measuring medical students\u0026rsquo; attitudes toward euthanasia have reported similar findings. For instance, research conducted among third- to fifth-year medical students at Stellenbosch University, South Africa, showed that most participants believed the practices of euthanasia/PAS should be legalized in South Africa. Another study among final-year medical students at Khartoum University contradicted our findings, reporting that the majority (76.6%) opposed euthanasia due to ethical considerations, religious beliefs, and fear of misuse. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) Similar findings regarding religious beliefs were also recorded among medical students in Hong Kong and New Zealand.(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) Religious medical students may oppose euthanasia because the practice often conflicts with their faith-based beliefs.\u003c/p\u003e \u003cp\u003eA central argument for euthanasia is the principle of respecting the patient\u0026rsquo;s autonomy. Our study observed a fairly positive perspective of euthanasia under ethical consideration primarily due to the respondents\u0026rsquo; firm belief in autonomy, implying that they believe in patients\u0026rsquo; right to decide what they consider proper care. However, for many, the principles of beneficence and non-maleficence remain firm, even in the face of complex and emotionally charged end-of-life decisions. Over two-thirds of our respondents agree that a physician must prolong and not end life, and the idea of ending a patient\u0026rsquo;s life is a violation of their commitment to care and heal, rather than to harm. The ethical principles of beneficence and non-maleficence guide medical professionals to act in the best interests of their patients and avoid causing harm. This study highlights that these values pose significant barriers to the acceptance of euthanasia among medical students.\u003c/p\u003e \u003cp\u003eMost respondents have a good attitude towards euthanasia regarding intractable suffering and impossible recovery, which is consistent with a previous study in Brazil.(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e) This concern supports the argument that euthanasia could be a compassionate response to intractable suffering. Some participants believe that the right to euthanasia and assisted suicide for terminally ill patients with no hope of recovery does not conflict with the right to life. If patients, healthcare providers, and society believe that the only way to alleviate suffering is through death, giving the patient the option of euthanasia could be viewed as allowing the patient to die with dignity. This perspective may shed light on why most of our participants supported the acceptance of euthanasia in our society.\u003c/p\u003e \u003cp\u003eAnother primary concern emerging is the fear that euthanasia could lead to abuse. More than half of the respondents worry that legalizing euthanasia could open the door to the mistreatment of vulnerable patients, particularly those who might be pressured by family or society to end their lives prematurely. Minors, the elderly, and people with psychiatric disorders are highly vulnerable to this pressure. Similar findings were seen in a study that compared medical students from different countries, views towards euthanasia.(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) Most respondents agreed that euthanasia poses a risk of abuse, underscoring the need for stringent safeguards if it were ever to be legalized. More than two-thirds (80.1%) of participants stated that they would prefer a dedicated ethics committee to decide who receives euthanasia/PAS. These concerns are not easily dismissed and point to a critical challenge: how to protect vulnerable individuals while also considering the suffering of patients who might desire euthanasia as a means of ending their pain.\u003c/p\u003e \u003cp\u003eAdditionally, we observed a more favourable view of euthanasia among Fifth-year medical students compared to their fourth-year counterparts. This difference in perspective may be attributed to their increased exposure to various medical experiences and departments. However, our findings do not align with previous studies in New Zealand and Brazil, which reported a more negative attitude toward euthanasia among senior medical students compared to their younger peers.(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eCurrently, multi-center studies across various regions are needed to better understand medical students\u0026rsquo; perspectives towards euthanasia in Nigeria. Significant changes should be made in the medical curriculum by introducing medical ethics early, allowing students to explore the moral, cultural, and personal implications of euthanasia. Case studies and simulations can expose students to the emotional and intellectual complexities they may face in real-life situations. These exercises should include scenarios that explore religious, cultural, and economic factors influencing end-of-life decisions.\u003c/p\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eGiven the moral, religious, and social sensitivity of euthanasia, the use of a self-reported survey may have introduced social desirability bias, with participants providing answers that they deem as more socially acceptable. Additionally, medical students\u0026rsquo; attitude towards euthanasia may shift over time, due to increased clinical exposure and personal experience, highlighting a major limitation in cross-sectional studies.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study explores medical student\u0026rsquo;s attitudes toward euthanasia in Nigeria. They hold a nuanced view towards euthanasia, broadly supporting its right under specific circumstances yet expressing concerns over potential abuse and the ethical responsibility of physicians to preserve life. The tension between alleviating suffering and preventing harm is at the core of the euthanasia debate. While some participants recognized that there might be cases where euthanasia could be justified, the overwhelming concern about its potential for abuse and the erosion of trust in healthcare systems suggests that many believe it is better to err on the side of caution. Medical students must be aware of the different arguments on euthanasia to enable better decision-making as future doctors.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of Interest Statement and Funding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no funding, financial relationships or conflicts of interest to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEAE: made substantial contribution to the conceptualization, writing, data analysis and reviewing of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work.\u003c/p\u003e\n\u003cp\u003ePMW: \u0026nbsp;made substantial contribution to the writing, data collection, and reviewing of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work.\u003c/p\u003e\n\u003cp\u003eCCU: \u0026nbsp; made substantial contribution to the writing, data collection and reviewing of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work.\u003c/p\u003e\n\u003cp\u003eBMU: \u0026nbsp;made substantial contribution to the writing, and reviewing, of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work.\u003c/p\u003e\n\u003cp\u003eACO: made substantial contribution to the writing, data collection and reviewing of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work.\u003c/p\u003e\n\u003cp\u003eIBA: made substantial contribution to data collection and analysis of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work.\u003c/p\u003e\n\u003cp\u003eEIA: made substantial contribution to the writing of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work.\u003c/p\u003e\n\u003cp\u003eEUS: made substantial contribution to the writing of the study, and has approved the submitted version. They agreed to be accountable for the authors contribution and questions related to the accuracy or integrity of any part of the work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData is provided within the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKhan YB, Abukhait RO, Fatma Abdulwahab Dehlab. Contemplating the controversy: Exploring the Ethics and Realities of Euthanasia. Int J Sci Res Arch. 2024;11(2):2058\u0026ndash;66.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEuthanasia -. MU School of Medicine [Internet]. [cited 2024 May 3]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://medicine.missouri.edu/centers-institutes-labs/health-ethics/faq/euthanasia\u003c/span\u003e\u003cspan address=\"https://medicine.missouri.edu/centers-institutes-labs/health-ethics/faq/euthanasia\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFontalis A, Prousali E, Kulkarni K. Euthanasia and assisted dying: what is the current position and what are the key arguments informing the debate? J R Soc Med. 2018;111(11):407\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePalliative care [Internet]. [cited 2024 Jul 5]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/news-room/fact-sheets/detail/palliative-care\u003c/span\u003e\u003cspan address=\"https://www.who.int/news-room/fact-sheets/detail/palliative-care\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eClark D, Baur N, Clelland D, Garralda E, L\u0026oacute;pez-Fidalgo J, Connor S, et al. Mapping Levels of Palliative Care Development in 198 Countries: The Situation in 2017. J Pain Symptom Manag. 2020;59(4):794.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEke GK, Ndukwu GU, Chukwuma NS, Diepiri BB. Knowledge and perception of healthcare providers towards palliative care in Rivers State, Nigeria. Port Harcourt Med J. 2017;11(3):156.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmzat J, Kanmodi KK, Ismail A, Egbedina EA. Euthanasia in Africa: A scoping review of empirical evidence. Health Sci Rep. 2023;6(5):e1239.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThe ethics of euthanasia - Australian Medical Student Journal [Internet]. 2012 [cited 2024 Jun 24]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.amsj.org/archives/2066\u003c/span\u003e\u003cspan address=\"https://www.amsj.org/archives/2066\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNew Zealand medical. students\u0026rsquo; views of euthanasia/assisted dying across different year levels | BMC Medical Education | Full Text [Internet]. [cited 2024 Dec 24]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://bmcmededuc.biomedcentral.com/articles/\u003c/span\u003e\u003cspan address=\"https://bmcmededuc.biomedcentral.com/articles/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12909-021-02558-2\u003c/span\u003e\u003cspan address=\"10.1186/s12909-021-02558-2\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLau AMY, Wong ELY. Attitude towards Euthanasia among Medical Students: A Cross-Sectional Study in Hong Kong. Int J Environ Res Public Health. 2022;19(13):7697.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGutierrez-Castillo A, Castillo J, Guadarrama-Conzuelo F, Jimenez-Ruiz A, Ruiz-Sandoval JL. Euthanasia and physician-assisted suicide: a systematic review of medical students\u0026rsquo; attitudes in the last 10 years. J Med Ethics History Med. 2020;13:1\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLeppert W, Gottwald L, Majkowicz M, Kazmierczak-Lukaszewicz S, Forycka M, Cialkowska-Rysz A, et al. A Comparison of Attitudes Toward Euthanasia Among Medical Students at Two Polish Universities. J Cancer Educ. 2012;28(2):384.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJacobs RK, Hendricks M. Medical students\u0026rsquo; perspectives on euthanasia and physician-assisted suicide and their views on legalising these practices in South Africa. South Afr Med J. 2018;108(6):484\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e(PDF) Changing attitudes towards euthanasia among medical students in Austria [Internet]. [cited 2024 Nov 3]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.researchgate.net/publication/49653885_Changing_attitudes_towards_euthanasia_among_medical_students_in_Austria\u003c/span\u003e\u003cspan address=\"https://www.researchgate.net/publication/49653885_Changing_attitudes_towards_euthanasia_among_medical_students_in_Austria\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNaseh L, Rafiei H, Heidari M. Nurses\u0026rsquo; attitudes towards euthanasia: a cross-sectional study in Iran. Int J Palliat Nurs. 2015;21(1):43\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAhmed AM, Kheir MM. Attitudes towards euthanasia among final-year Khartoum University medical students. EMHJ - Eastern Mediterranean Health Journal, 12 (3\u0026ndash;4), 391\u0026ndash;397, 2006 [Internet]. 2006 [cited 2024 Aug 23]; Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://iris.who.int/handle/10665/117098\u003c/span\u003e\u003cspan address=\"https://iris.who.int/handle/10665/117098\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDedivitis RA, de Matos LL, de Castro MAF, de Castro AAF, Giaxa RR, Tempski PZ. Medical students\u0026rsquo; and residents\u0026rsquo; views on euthanasia. BMC Med Ethics. 2023;24(1):109.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eForycka M, Leppert W, Majkowicz M. Attitudes toward euthanasia among medical students from different countries. Oncol Clin Pract. 2022;18(5):275\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Euthanasia, Medical Students, Nigeria","lastPublishedDoi":"10.21203/rs.3.rs-6749981/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6749981/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eAs future doctors, medical students are often confronted with the topic of euthanasia while fulfilling their roles in caring for terminally ill patients. Despite the complex ethical, legal, and cultural debates surrounding euthanasia globally, the attitudes of medical students towards it remain unexplored in Nigeria. This paper aims to investigate medical students' attitudes towards euthanasia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodology\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eA cross-sectional study was conducted among 126 clinical students at the University of Calabar's Faculty of Clinical Sciences. The sample size was determined using the Taro Yamane formula. Participants were selected using simple random sampling and were administered a sociodemographic questionnaire and the Euthanasia Attitude Scale (EAS). Data was analyzed using IBM SPSS version 26.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eThe sample's mean age was 23.9 (2.74) years, and more were female (54.5%). We found that 68.6% believed in the patient’s right to choose euthanasia in terminal illnesses, and 65.3% saw its utility in specific contexts. Over half (56.2%) supported societal acceptance of euthanasia, especially when recovery was impossible (53.7%) or to reduce family burden in terminal cases (50.4%). Regarding conditions for euthanasia, most opposed using terminal illness (47.9%) or old age (43.0%) as general criteria, while57.9% feared it would be abused.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eThe study concludes that medical students at the University of Calabar hold a nuanced view towards euthanasia, predominantly supporting its right under specific circumstances yet expressing concerns over potential abuses and the ethical responsibility of physicians to preserve life.\u003c/p\u003e","manuscriptTitle":"Medical Students’ Perspective on Euthanasia in Calabar, Nigeria: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-26 08:44:31","doi":"10.21203/rs.3.rs-6749981/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-08-04T14:29:12+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-04T13:19:42+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-25T09:44:58+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-13T10:36:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"47397208527871818041928175600488080963","date":"2025-07-11T14:05:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"168616993305793480684137592326088136616","date":"2025-07-11T07:59:42+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-08T18:05:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"222832856051096990395074123534049076144","date":"2025-07-07T15:15:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"274865538132184236170117907912896521539","date":"2025-07-03T11:28:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"331929279390567673146658623786552228792","date":"2025-07-01T10:09:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"320667595651415092190270566307216655130","date":"2025-06-28T07:23:31+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-24T07:42:26+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-30T14:08:28+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-29T06:31:54+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-29T06:30:20+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-05-26T10:37:53+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"56cd3389-4e7a-4f0f-9677-b309e3316dc5","owner":[],"postedDate":"June 26th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-15T14:23:13+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-26 08:44:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6749981","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6749981","identity":"rs-6749981","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}