Experiences of Oregon Nurses and Social Workers with Hospice Patients Who Requested Assistance with Suicide
Linda Ganzini, M.D., Theresa A. Harvath, R.N., Ph.D., Ann Jackson, M.B.A., Elizabeth R. Goy, Ph.D., Lois L. Miller, Ph.D., R.N., and Molly A. Delorit, B.A.
Background Oregon's 1997 Death with Dignity Act legalizes physician-assistedsuicide. To date, information about patients who have requestedthis option has come from surveys of physicians. Although 78percent of the 91 Oregonians who have died by assisted suicidewere enrolled in hospice programs, there is little informationabout the experiences of hospice practitioners with these patients.
Methods In 2001, we mailed a questionnaire to all hospice nursesand social workers in Oregon.
Results Of 545 eligible hospice nurses and social workers, 397(73 percent) returned the survey, including 71 percent of nursesand 78 percent of social workers. Since November 1997, 179 ofthe respondents (45 percent) had cared for a patient who requestedassistance with suicide. Hospice nurses reported on 82 patientswho had received prescriptions for lethal medication. Ninety-eightpercent of the nurses had discussed the request with a coworker,and 77 percent of the requests had been presented at a hospiceinterdisciplinary conference on patient care. A very importantreason for the request was to control the circumstances of death.The least important reasons included depression, lack of socialsupport, and fear of being a financial drain on family members.Although the patients were concerned about burdening others,only 11 percent of hospice nurses rated their family caregiversas more burdened than family caregivers for other hospice patients.
Conclusions Since assisted suicide was legalized in Oregon,many hospice nurses and social workers have provided care fora patient who requested assistance with suicide. They rateddesire for control as a very important reason for these requests.
Source Information
From the Portland Veterans Affairs Medical Center (L.G., E.R.G., M.A.D.); the Department of Psychiatry (L.G., E.R.G.) and School of Nursing (T.A.H., L.L.M.), Oregon Health and Science University; and the Oregon Hospice Association (A.J.) all in Portland.
Address reprint requests to Dr. Ganzini at the Mental Health Division, P3MHDC, Portland Veterans Affairs Medical Center, P.O. Box 1034, Portland, OR 97207, or at ganzinil{at}ohsu.edu.
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