CLINICAL ETHICS Attitudes of Finnish doctors towards euthanasia in 1993 and

Questionnaire studies on the attitudes of Finnish doctors towards euthanasia were conducted in 1993 and 2003, and the results show that they have not become more positive. T he attitudes of doctors towards active euthanasia are, in general, more negative than the attitudes of the general public. The interpretations of surveys are, however, highly dependent on the formulation of the questions and, although the questions posed to these groups are similar, it is probable that the interpretations of doctors differ from those of the general public. According to most studies, most doctors, except those from The Netherlands, are against legalisation on active euthana-sia. Considerable variation exists in the percentage of doctors opposing the practice. The variation is, of course, partly because of the variation in opinion, but several methodolo-gical issues also explain it. Some studies have asked direct questions about the legalisation of euthanasia—for example, in others, the questions have been about the ethical acceptance of the practice. Some studies have used case vignettes, whereas others have used general questionnaires. The knowledge and availability of palliative care may also affect the answers.1 The definition of euthanasia is of particular importance in the studies. The distinction between passive euthanasia (ie, withholding or withdrawing life-saving treatment) and active euthanasia (ie, deliberately terminating the life of the patient with a lethal drug, for example,) has not always been clear. Although numerous studies with different methods have focused on the attitudes of doctors towards euthanasia and other practices at the end of life, we lack knowledge on possible changes in these attitudes. Legal changes in The Netherlands and Belgium, and open public discussion on these issues, most recently in the Council of Europ