Top Reason For Patients Requesting Physician-Assisted Suicide: Worries About The Future

Main Category: Palliative Care / Hospice Care
Also Included In: Primary Care / General Practice;  Psychology / Psychiatry;  Cancer / Oncology
Article Date: 10 Mar 2009 - 6:00 PDT

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Oregon patients who request physician aid in dying under Oregon's Death With Dignity Act often rate concerns about future illness symptoms as a leading motivator. The findings are the result of an Oregon Health & Science University study published in the March 9 edition of the Archives of Internal Medicine.

"Our data suggests that patients who request physician-assisted death do so not because of physical symptoms or their current quality of life. They often make their requests based on an anticipation of future suffering," explained Linda Ganzini, M.D., a professor of psychiatry in the OHSU School of Medicine.

Previous studies of the factors for requests of physician aid in dying were based on interviews and surveys conducted with health care providers and family members following a loved one's death. The goal of this study was to directly survey patients about their reasons for requesting assistance, before death via physician aid or other circumstances.

A total of 56 Oregonians took part in the study. All of the patients had requested physician aid in dying or had contacted an advocacy organization for information. The vast majority of patients were diagnosed with terminal cancer.

Each of these patients was asked to rate on a 5-point scale the importance of 29 factors in influencing their request for aid in dying. The highest ranked reasons for aid in dying were: wanting to control the circumstances of their death, concerns about future poor quality of life, concerns about future pain, concerns about the future ability to care for oneself, a loss of independence and the desire to die at home. Among the lowest rated reasons for requesting assistance were: depression, lack of support, financial concerns, current pain and quality of life.

The findings are being published as a second U.S. state enacts a law allowing physician-assisted suicides to take place. On Thursday, March 5, Washington became the second state in the country to allow physicians to prescribe lethal medications. Oregon's assisted suicide law was enacted in 1998.

"We hope that the results of this study will help guide providers in counseling patients who inquire about physician aid in dying," added Ganzini. "Based on this data, health care providers should first focus on providing information about future symptom control and improving the patient's sense of control."

Notes:

About Oregon Health & Science University

Oregon Health & Science University is the state's only health and research university and Oregon's only academic health center. OHSU is Portland's largest employer and the fourth largest in Oregon (excluding government). OHSU's size contributes to its ability to provide many services and community support activities not found anywhere else in the state. It serves patients from every corner of the state, and is a conduit for learning for more than 3,400 students and trainees. OHSU is the source of more than 200 community outreach programs that bring health and education services to every county in the state.

Source: Jim Newman
Oregon Health & Science University