The interview first addressed the subject's general attitudes toward the acceptability and legal status of both euthanasia and physician-assisted suicide. They were also audiotaped for later transcription. All interviews were attended by both a primary interviewer and an observer, to permit the evaluation of interrater reliability. The semistructured interviews were conducted by a clinical psychologist, doctoral students in psychology, or a research associate in palliative care. 9 - 11 The goals were to examine patients' attitudes toward these practices and to investigate the factors that are related to the personal interest in receiving a physician-hastened death. In this study, we examined attitudes toward euthanasia and physician-assisted suicide in the group that would be most affected by legalization-patients who are nearing death from advanced cancer, the diagnosis of 65% to 80% of those who receive hastened deaths in the Netherlands. 14 - 16 These studies indicate that both physical and psychosocial considerations are relevant in the assisted-suicide debate, but they are limited because they have been conducted (1) with physicians rather than with the patients themselves or (2) with patients who were not necessarily close to death, when these decisions would be most salient. 9 - 13 Finally, there are surveys of physicians in other areas who have provided euthanasia or assisted suicide, albeit illegally, to patients in their care. 1 - 8 There are also reports from the Netherlands, the Australian Northern Territory, and the US state of Oregon that have described the characteristics of patients who have died by these methods in jurisdictions where they have been permitted. Studies have been conducted with various groups of patients who have life-threatening illnesses. WITH THE ongoing societal debate around the issue of legalizing voluntary euthanasia or physician-assisted suicide for terminally ill patients, there has been a growing interest in identifying the concerns of those who would be most likely to make requests for a hastened death. For patients who would actually make requests for a physician-hastened death, however, psychological considerations may be at least as salient as physical symptoms. However, they did not differ on ratings of pain severity.Ĭonclusions Many patients with advanced cancer favor policies that would allow them access to both euthanasia and physician-assisted suicide if pain and physical symptoms became intolerable. They also had a higher prevalence of depressive disorders ( P<.05). These 8 participants differed from all others on ratings of loss of interest or pleasure in activities, hopelessness, and the desire to die ( Ps<.02). Eight of these individuals (12%) would have made such a request at the time of the interview. Forty (58%) of the 69 participants who completed the entire interview also believed that, if legal, they might personally make a future request for a hastened death, particularly if pain or physical symptoms became intolerable. Participants who were opposed to legalization cited religious and moral objections as their central concerns. Results Most participants (73%) believed that euthanasia or physician-assisted suicide should be legalized, citing pain and the individual's right to choose as their major reasons. The interviews were audiotaped for transcription and content analysis of themes. Methods Seventy patients (32 men and 38 women median survival, 44.5 days) took part in a survey using in-depth semistructured interviews. We investigated the personal attitudes toward these practices of patients receiving palliative care for advanced cancer. Shared Decision Making and Communicationīackground In jurisdictions that permit euthanasia or physician-assisted suicide, patients with cancer comprise the largest group to die by these methods.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment. Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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