ON EUTHANASIA: EXPLORING PSYCHOLOGICAL MEANING AND ATTITUDES IN A SAMPLE OF MEXICAN PHYSICIANS AND MEDICAL STUDENTS ASUNCIÓN ÁLVAREZ DEL RÍO AND MA. LUISA MARVÁN Keywords medical ethics, Mexico, euthanasia ABSTRACT Euthanasia has become the subject of ethical and political debate in many countries including Mexico. Since many physicians are deeply concerned about euthanasia, due to their crucial participation in its decision and implementation, it is important to know the psychological meaning that the term ‘euthanasia’ has for them, as well as their attitudes toward this prac- tice. This study explores psychological meaning and attitudes toward euthanasia in 546 Mexican subjects, either medical students or physicians, who were divided into three groups: a) beginning students, b) advanced students, and c) physicians. We used the semantic networks technique, which analyzed the words the participants associated with the term ‘eutha- nasia’. Positive psychological meaning, as well as positive attitudes, pre- vailed among advanced students and physicians when defining euthanasia, whereas both positive and negative psychological meaning together with more ambivalent attitudes toward euthanasia predominated in beginning students. The findings are discussed in the context of a current debate on a bill proposing active euthanasia in Mexico City. INTRODUCTION Euthanasia can be defined as deliberately ending a patient’s life at the patient’s request. More precisely, from the Dutch perspective, it can be defined as ‘the situation in which a doctor ends the life of a person who is suffering unbearably and hopelessly at the latter’s explicit request’. 1 According to this definition, it is understood that the doctor ends the person’s life through a direct action, such as administering a lethal medication, in what has been called active euthanasia to distinguish it from passive euthanasia, which refers to the withholding or withdrawing of treatment thus allowing the person to die. 2 Although this distinction is no longer part of the Dutch discussion, it is still used in other countries, even though the term passive euthanasia tends to be replaced by limitation of thera- peutic activity. 3 In this article, when we use the term euthanasia, we mean active euthanasia unless otherwise specified. Euthanasia allows patients to remain free to make deci- sions till the last moment of their lives. As far as physi- cians are concerned, euthanasia may be the only feasible way to help certain patients relieve their suffering accord- ing to their own wishes. The Netherlands was the first country to legally allow euthanasia provided that a phy- sician acts in accordance with the criteria of due care: basically, a well-considered and voluntary request by a fully informed patient with unbearable suffering and no reasonable alternatives. An independent physician 1 A. William. Euthanasia and Law in Europe. JAMA 2008; 300: 1706. 2 J. Rachels. Active and Passive Euthanasia. N Engl J Med 1975; 292(2): 78–80. 3 L. Cabré-Pericas & J.F. Solsona-Durán. Limitación del Esfuerzo Terapéutico en Medicina Intensiva. Med Intensiva 2002; 26(6): 304– 311. Address for correspondence: Asunción Álvarez del Río, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, UNAM, Circuito Exterior, Ciudad Universitaria, México DF CP 04510, Mexico. Email: asun57@gmail.com. Conflict of interest statement: No conflicts declared Developing World Bioethics ISSN 1471-8731 (print); 1471-8847 (online) doi:10.1111/j.1471-8847.2011.00308.x Volume 11 Number 3 2011 pp 146–153 bioethics developing world © 2011 Blackwell Publishing Ltd., 9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA.