Euthanasia and physician-assisted suicide: a systematic review of medical students' attitudes in the last 10 years.

This study aimed at examining the approval rate of the medical students' regarding active euthanasia, passive euthanasia, and physician-assisted-suicide over the last ten years. To do so, the arguments and variables affecting students' choices were examined and a systematic review was conducted, using PubMed and Web of Science databases, including articles from January 2009 to December 2018. From 135 identified articles, 13 met the inclusion criteria. The highest acceptance rates for euthanasia and physician-assisted suicide were from European countries. The most common arguments supporting euthanasia and physician-assisted suicide were the followings: (i) patient's autonomy (n = 6), (ii) relief of suffering (n = 4), and (ii) the thought that terminally-ill patients are additional burden (n = 2). The most common arguments against euthanasia were as follows: (i) religious and personal beliefs (n = 4), (ii) the "slippery slope" argument and the risk of abuse (n = 4), and (iii) the physician's role in preserving life (n = 2). Religion (n = 7), religiosity (n = 5), and the attributes of the medical school of origin (n = 3) were the most significant variables to influence the students' attitude. However, age, previous academic experience, family income, and place of residence had no significant impact. Medical students' opinions on euthanasia and physician-assisted suicide should be appropriately addressed and evaluated because their moral compass, under the influence of such opinions, will guide them in solving future ethical and therapeutic dilemmas in the medical field.

Cathrombosis: Deep Vein Thrombosis After a Cat Bite - A Case Report.

Cat bites represent between 5-15% of all animal bites and are sometimes encountered by primary care and emergency department physicians. Other than polymicrobial infections, very few other complications have been reported. We present the case of a 75-year-old male who developed deep vein thrombosis (DVT) in his left leg where he had been bitten by a cat four days prior. Although it is not possible to describe a causal relationship, we discuss whether these events are related.

Fatal Intracranial Hemorrhage Associated with Oral Warfarin Use.

Intracerebral hemorrhage is the most devastating complication in patients taking oral warfarin. Despite theoretic reversibility with fresh frozen plasma, vitamin K and prothrombin complex concentrate, it remains an entity with high mortality. Fluid-fluid level, also known as blood-fluid level, sedimentation level, or hematocrit effect, seen on noncontrast computed tomography (CT) scan is a characteristic finding associated with patients who have coagulopathy or who are receiving oral anticoagulation therapy. We present the case of an 80-year-old female patient requiring long-term anticoagulation due to atrial fibrillation, who presented acute neurological symptoms including thunderclap headache and hemiparesis. Urgent noncontrast CT scan showed classic signs of warfarin-induced intracranial hemorrhage with a fatal outcome a few hours after admission.

Septo-optic Dysplasia Plus Syndrome.

Septo-optic dysplasia plus is a rare congenital syndrome characterized by the classic triad of optic nerve hypoplasia, hypothalamic-hypophyseal dysfunction, and midline abnormalities, with associated malformations of cortical development. Clinical manifestations include optic nerve disease, epilepsy, intellectual delay, and endocrine dysfunction. We present the case of an 18-year-old man with a history of seizures, growth hormone deficiency, and optic nerve disease that was diagnosed with septo-optic dysplasia plus syndrome with characteristic imaging findings.

Active and Passive Euthanasia: Current Opinion of Mexican Medical Students.

BACKGROUND: The idea to accelerate the process of death in a terminally ill patient is an issue that has polarized societies since ancient times. The purpose of this study is to describe and analyze the opinion of medical students from Nuevo Leon, Mexico, about passive euthanasia, active euthanasia, and their personal posture on the topic. MATERIAL AND METHODS: Using a three-part questionnaire, 1,319 medical students of the first three years of medical school, from three of the four medical schools in the state, were interviewed. The questionnaire included questions on demographics, religion, and the personal posture of the student on active euthanasia, passive euthanasia, and their personal posture on the topic. RESULTS: Of those interviewed, 44.4% were in favor of active euthanasia, 52.1% of passive euthanasia, and 44.8% had a positive personal posture on the topic. Age and grade were not significant variables for the posture of the students, but the variable gender showed a predominantly positive posture in the male subgroup for active (p=0.001) and passive euthanasia (p=0.031). Religion and the importance of religion/spirituality in daily life were the most significant factors (p<0.005) for the interviewees to hold a negative posture in each of the three scenarios. The legal nature of the scenario (p=0.000) and respect for patient's autonomy (p=0.000) were the most important arguments that could change an original negative posture into a positive one.