Fear of Pain Drives Requests for Assisted Death

WEDNESDAY March 11, 2009 -- Concern about future suffering is the leading reason why terminally ill patients ask for physician-assisted death under Oregon's Death With Dignity Act, according to an Oregon Health & Science University study.

Researchers interviewed 56 people who had requested physician aid in dying or had contacted an advocacy group for information about physician-assisted death. Most of them had terminal cancer.

Each person was asked to rate on a five-point scale the importance of 29 factors in influencing their decision to request physician-assisted death. The leading reasons cited were:

  • Wanting to control the circumstances of their death
  • Concerns about poor quality of life in the future
  • Concerns about future pain
  • Concerns about the ability to care for themselves in the future
  • Loss of independence
  • Desire to die at home

The lowest-ranked reasons included depression, lack of support, financial concerns, current pain and quality of life.

"Our data suggest that patients who request physician-assisted death do so not because of physical symptoms or their current quality of life," Dr. Linda Ganzini, a psychiatry professor at the Oregon Health & Science University, said in a university news release. "They often make their requests based on an anticipation of future suffering."

The study was published in the March 9 issue of Archives of Internal Medicine.

"We hope that the results of this study will help guide providers in counseling patients who inquire about physician aid in dying," Ganzini said. "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."

In 1998, Oregon became the first state to legalize physician-assisted death. Last week, Washington became the second state to allow physicians to prescribe lethal medications to dying patients.

More information

The U.S. National Cancer Institute lists questions and answers about end-of-life care.

Posted: March 2009


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