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Previous Volume 339:967-973 October 1, 1998 Number 14 Next

	Full Text PDF Editorial by Rowland, L. P. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background and Methods Amyotrophic lateral sclerosis (ALS) is a neuromuscular disease that causes gradual paralysis, respiratory failure, and death, usually within three to five years after it has been diagnosed. Between 1995 and 1997, we surveyed patients with this disease in Oregon and Washington, as well as their family care givers, in order to determine their attitudes toward assisted suicide. Patients were considered to be willing to contemplate assisted suicide if they agreed with the statement, "Under some circumstances I would consider taking a prescription for a medicine whose sole purpose was to end my life," and disagreed with the statement, "I would never request or take a prescription for a medication whose sole purpose was to end my life." The Oregon Death with Dignity Act, which legalized physician-assisted suicide, was approved by Oregon voters in 1994 but did not go into effect until October 1997, after data collection for this study had been completed.

Results Of 140 eligible persons with ALS, 100 (71 percent) agreed to participate in the study, as did 91 family care givers. The mean age of the patients with ALS was 54 years; the mean duration of illness since the diagnosis was 2.8 years. Fifty-six patients (56 percent) said they would consider assisted suicide, and 44 of the 56 agreed with the statement, "If physician-assisted suicide were legal, I would request a lethal prescription from a physician." One patient would have taken the medication immediately, and 36 would have kept it for future use. As compared with the patients who were opposed to assisted suicide, those who would consider it were more likely to be men, had a higher level of education, were less likely to be religious, had higher scores for hopelessness, and rated their quality of life as lower. In 66 of 91 instances (73 percent), care givers and patients had the same attitude toward assisted suicide.

Conclusions In Oregon and Washington, a majority of persons with ALS whom we surveyed would consider assisted suicide. Many would request a prescription for a lethal dose of medication well before they intended to use it.

Source Information

From the Departments of Psychiatry (L.G., B.H.M.), Neurology (W.S.J.), and Medicine (S.W.T., M.A.L.) and the Center for Ethics in Health Care (L.G., S.W.T.), Oregon Health Sciences University; the Portland Veterans Affairs Medical Center (L.G.); and Providence ElderPlace (M.A.L.) — all in Portland, Oreg. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs, Providence Health Systems, or Oregon Health Sciences University.

Address reprint requests to Dr. Ganzini at the Mental Health Division (P-7-1DMH), Portland Veterans Affairs Medical Center, P.O. Box 1034, Portland, OR 97207.

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