Attitudes toward Euthanasia in Medical Personnel Scale (AHE-PM)

Abstract

The Attitudes towards Euthanasia in Medical Personnel Scale (AHE-PM), known in Spanish as Cuestionario de Actitudes Hacia la Eutanasia en Personal Médico, is a concise, six-item Rating Scale developed in 2023 by Puente-López et al. Its core purpose is to rigorously assess the complex perspectives of Medical Professionals regarding Euthanasia.

The scale is structurally defined by two distinct factors: “Attitudes towards euthanasia to avoid suffering due to poor prognosis” and “Attitudes towards euthanasia to avoid emotional suffering.” Developed using data collected from physicians across three Spanish provinces within the autonomous community of Andalusia, the AHE-PM underwent stringent validation procedures. Both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) confirmed a robust two-factor model and excellent data fit. The instrument is designed for efficient administration, requiring only a few minutes for completion, and exhibits high internal consistency across both dimensions.

Keywords

Attitudes Towards Euthanasia, Avoid Emotional Suffering, Avoid Suffering Due to Poor Prognosis, Physicians, Right to Die, Health Personnel Attitudes, Health Care Personnel Measures.

Authors

Puente-López, Esteban, Ruiz-Cabello, Aurelio Luna, Pina, David, Maldonado, Aurelio Luna, Haro Kay, María José, Lorente Sánchez, Mauricio, Gamero Lucas, Joaquín.

Purpose

The primary purpose of the AHE-PM is to meticulously evaluate the attitudes of medical staff towards the sensitive and ethically complex practice of euthanasia. This instrument aims to provide a standardized and reliable method for understanding the nuanced perspectives of healthcare professionals on end-of-life decision-making.

By focusing specifically on the medical personnel population, the scale allows researchers to isolate and quantify professional and ethical viewpoints regarding euthanasia, distinguishing between motivations related to physical suffering versus psychological distress.

Construct

The AHE-PM measures the psychological construct of Attitudes towards Euthanasia, specifically within the context of clinical responsibilities among Medical Professionals. This construct is operationalized through two empirically validated, distinct dimensions:

• Attitudes towards euthanasia to avoid suffering due to poor prognosis (focusing on irreversible physical conditions).
• Attitudes towards euthanasia to avoid emotional suffering (focusing on psychological distress).

The scale, therefore, provides a measure of how professional ethics and personal beliefs intersect when healthcare providers consider allowing the right to die based on the patient’s condition.

Validity

Explicit data regarding external validity (e.g., convergent or criterion validity) were not reported in the source material. However, the rigorous structural validation achieved through both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) provides strong support for the scale’s construct validity, confirming that the items accurately measure the intended theoretical dimensions.

Reliability

The AHE-PM demonstrates strong internal consistency across its factors, indicating a reliable relationship among the items used to measure each dimension.

Internal Consistency: The reliability was assessed using Cronbach’s alpha. The coefficients for both of the identified factors were reported as .86. This high value confirms that the items consistently measure the underlying construct, ensuring the measurement accuracy of the scale.

Factor Analysis

The structural integrity of the AHE-PM was rigorously established through both exploratory and confirmatory statistical methods.

Exploratory Factor Analysis (EFA): An Exploratory Factor Analysis was conducted using the unweighted least squares method with normalized Varimax rotation. This analysis successfully identified the hypothesized two-factor structure. These two factors accounted for a significant cumulative percentage of the variance, explaining 58.32% and 34.91% of the total variance, respectively. Data suitability for factoring was confirmed by a Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy of .750, and Bartlett’s sphericity test yielded a highly statistically significant result (χ² = 2085.0, p < .0001).

Confirmatory Factor Analysis (CFA): A Confirmatory Factor Analysis was subsequently performed to evaluate how well the observed data fit the proposed two-factor model. All fit estimators obtained from the CFA indicated that the model provided an excellent fit to the observed data, thereby confirming the theoretical structure and empirical validation of the scale.

Instrument

Test Type: Original

Format: Rating Scale (6 items)

Language Available: English

Population Group: Human (Male and Female)

Age Group: Adulthood (18 years & older), including Young Adulthood (18-29 years), Thirties (30-39 years), Middle Age (40-64 years), and Aged (65 years & older).

Population Details: The target population for the AHE-PM consists exclusively of physicians. Data for the scale’s development and validation were collected from medical professionals located in Spain.

Test Methodology: The development involved robust Psychometric methodologies, including Test Reliability assessments (Internal Consistency via Cronbach’s alpha), Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA).

Keywords

Attitudes Towards Euthanasia, Avoid Emotional Suffering, Avoid Suffering Due to Poor Prognosis, Physicians, Right to Die, Health Personnel Attitudes, Health Care Personnel Measures.

Authors

The primary authors and collaborators involved in the development and validation of the AHE-PM are detailed below, along with their affiliations and contact information:

• Puente-López, Esteban
  • ORCID Identifier: No data is Available
  • Affiliation: University of Nebrija, Faculty of Natural Science, Department of Psychology
  • Email Address: [email protected]
• Ruiz-Cabello, Aurelio Luna
  • ORCID Identifier: No data is Available
  • Affiliation: University of Murcia, Faculty of Medicine, Department of Sociohealth Sciences
  • Email Address: [email protected]
• Pina, David
  • ORCID Identifier: No data is Available
  • Affiliation: University of Murcia, Faculty of Medicine, Department of Sociohealth Sciences
  • Email Address: [email protected]
• Maldonado, Aurelio Luna
  • ORCID Identifier: No data is Available
  • Affiliation: University of Murcia, Faculty of Medicine, Department of Sociohealth Sciences
  • Email Address: [email protected]
• Haro Kay, María José
  • ORCID Identifier: No data is Available
  • Affiliation: University of Cadiz, Faculty of Medicine
  • Email Address: [email protected]
• Lorente Sánchez, Mauricio
  • ORCID Identifier: No data is Available
  • Affiliation: University of Cadiz, Faculty of Medicine
  • Email Address: [email protected]
• Gamero Lucas, Joaquín
  • ORCID Identifier: No data is Available
  • Affiliation: University of Cadiz, Faculty of Medicine
  • Email Address: [email protected]

Correspondence Address: Ruiz-Cabello, Aurelio Luna: University of Murcia Espinardo, Faculty of Medicine, Department of Sociohealth Sciences, Murcia, Spain, [email protected]

Permissions & Fee and Test Year

Permissions: To obtain permissions for the use of the AHE-PM, it is recommended that researchers contact the Corresponding Author, Aurelio Luna Ruiz-Cabello.

Fee: The AHE-PM is a non-commercial instrument and does not require any fee for its use.

Test Year: The AHE-PM was developed and published in 2023.

Reference’s

Puente-López, E., Ruiz-Cabello, A. L., Pina, D., Luna Maldonado, A., Haro Kay, M. J., Lorente Sánchez, M., & Gamero Lucas, J. (2023). Euthanasia Attitudes Questionnaire in Medical Personnel (AHE-PM). Interdisciplinaria Revista de Psicología y Ciencias Afines, 40(1), 351–362.

Items of the Attitudes towards Euthanasia in Medical Personnel Scale (AHE-PM)

The Attitudes towards Euthanasia in Medical Personnel Scale (AHE-PM) consists of 6 items. While the specific wording of each item is not provided, the scale is structured around two primary factors, each contributing to the assessment of attitudes towards euthanasia in medical professionals.

The exact items can be found in the source publication: Puente-López, E., Ruiz-Cabello, A. L., Pina, D., Luna Maldonado, A., Haro Kay, M. J., Lorente Sánchez, M., & Gamero Lucas, J. (2023). Euthanasia Attitudes Questionnaire in Medical Personnel (AHE-PM). Interdisciplinaria Revista de Psicología y Ciencias Afines, 40(1), 351–362, specifically in Table 2, Pages 356-357.

Factors and Subscales:

1. Attitudes towards euthanasia to alleviate suffering due to poor prognosis: This factor measures the medical professional’s willingness to consider euthanasia when a patient is experiencing significant physical suffering with no hope of recovery.

2. Attitudes towards euthanasia to avoid emotional suffering: This factor assesses the views of medical professionals on euthanasia as a means to alleviate a patient’s profound emotional distress.