Sollen wir Sterbehilfe leisten? Zum Einfluss des Medizinstudiums auf die moralischen Einstellungen der Studierenden und zum empirischen Nachweis der Wirkmächtigkeit ethischer Argumente in der Sterbehilfedebatte. Eine Umfrage unter Medizinstudierenden.

Few topics invoke as much controversy as euthanasia. The increasing ability of mod-ern medicine to prolong life is causing patients and their relatives to be more con-scious in dealing with death and dying. More and more often so-called end-of-life decisions have to be taken. Alongside living wills and the withholding or withdraw-ing of treatment, the morally controversial subjects of active euthanasia and physi-cian-assisted suicide have been raised more often over the past years. Several studies have been conducted to investigate the public opinion of these subjects. Likewise, the positions of medical students and physicians have been explored. Yet the focus of these surveys has mainly been put on the question, whether the different types of euthanasia should be legal or not. The moral attitudes of the different groups have been explored only little. In this study it has been examined how medical students in Marburg evaluate the moral admissibility of the four different types of euthanasia. For two of these, active euthanasia and physician-assisted suicide, various arguments that are currently used in the moral debate were presented to the students and their agreement with the ar-guments was evaluated. Additionally the effectiveness of these various arguments on the students’ moral judgment of both types of euthanasia was analyzed. The results have shown that the alleviation of symptoms with possible shortening of life is being largely seen as morally admissible. The same outcome was also found for the withholding or withdrawing of medical treatment as long as it was the patient’s wish, although in this case the moral acceptance was lower than expected. Active euthanasia has been morally rejected. In case of physician-assisted suicide, the moral judgment depended on the circumstances. For a patient with an incurable cancer disease and unbearable pain it has been widely evaluated as morally acceptable. In the cases of patients without the conditions of a lethal disease or intolerable pain, physician-assisted suicide has been rated as morally not admissible. The analysis of the effectiveness of different arguments for the moral judgment of active euthanasia and physician-assisted suicide has shown that two of the arguments are playing a very big role. The burden of the physician who is either performing active euthanasia or assisting suicide and the prohibition to kill as a moral principle have proven to influence the decision of the moral admissibility of both forms of euthanasia. In contrast to these findings, within the theoretical debate, the argument of the physicians’ burden is being rated less essential. Due to these findings it might be reasonable to consider the physicians’ burden more strongly in the debate about euthanasia. Another surprising outcome concerned the argument of patient autonomy, which proved to be very important for the moral judgment of physician-assisted suicide, but not so for the moral judgment of active euthanasia. Whether this is due to weighing the competing values, due to a paternalistic attitude or due to a material understand-ing of patients’ autonomy could not be answered in this study. The observation, that the autonomy of the patient has been differentiated regarding physician assisted sui-cide and active euthanasia suggests, that in the theoretical debate about euthanasia it has to be ensured that the normative-ethical concepts of the different arguments have to be known and understood.