Desire for euthanasia or physician-assisted suicide in palliative cancer care

• Published in: Health psychology Vol. 26; no. 3; p. 314
• Main Authors: Wilson, Keith G, Chochinov, Harvey Max, McPherson, Christine J, Skirko, Merika Graham, Allard, Pierre, Chary, Srini, Gagnon, Pierre R, Macmillan, Karen, De Luca, Marina, O'Shea, Fiona, Kuhl, David, Fainsinger, Robin L, Karam, Andrea M, Clinch, Jennifer J
• Format: Journal Article
• Language: English
• Published: United States 01.05.2007
• Subjects: Aged; Attitude to Death; Canada; Female; Humans; Interviews as Topic; Male; Middle Aged; Neoplasms; Palliative Care; Patient Satisfaction; Prospective Studies; Suicide, Assisted; Canada
• ISSN: 0278-6133
• DOI: 10.1037/0278-6133.26.3.314

To investigate the attitudes of terminally ill individuals toward the legalization of euthanasia or physician-assisted suicide (PAS) and to identify those who would personally desire such a death. In the Canadian National Palliative Care Survey, semistructured interviews were administered to 379 patients who were receiving palliative care for cancer. Patients who expressed a desire for physician-hastened death were followed prospectively. Attitudes toward the legalization of euthanasia or PAS were determined, as was the personal interest in receiving a hastened death. Demographic and clinical characteristics were also recorded, including a 22-item structured interview of symptoms and concerns. There were 238 participants (62.8%) who believed that euthanasia and/or PAS should be legalized, and 151 (39.8%) who would consider making a future request for a physician-hastened death. However, only 22 (5.8%) reported that, if legally permissible, they would initiate such a request right away, in their current situations. This desire for hastened death was associated with lower religiosity (p=.010), reduced functional status (p=.024), a diagnosis of major depression (p<.001), and greater distress on 12 of 22 individual symptoms and concerns (p<.025). In follow-up interviews with 17 participants, 2 (11.8%) showed instability in their expressed desire. Among patients receiving palliative care for cancer, the desire to receive euthanasia or PAS is associated with religious beliefs; functional status; and physical, social, and psychological symptoms and concerns. Although this desire is sometimes transitory, once firmly established, it can be enduring.