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Previous Volume 342:557-563 February 24, 2000 Number 8 Next

	Full Text PDF Editorial by Nuland, S. B. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article PubMed Citation

ABSTRACT

Background Physician-assisted suicide was legalized in Oregon in October 1997. There are data on patients who have received prescriptions for lethal medications and died after taking the medications. There is little information, however, on physicians' experiences with requests for assistance with suicide.

Methods Between February and August 1999, we mailed a questionnaire to physicians who were eligible to prescribe lethal medications under the Oregon Death with Dignity Act.

Results Of 4053 eligible physicians, 2649 (65 percent) returned the survey. Of the respondents, 144 (5 percent) had received a total of 221 requests for prescriptions for lethal medications since October 1997. We received information on the outcome in 165 patients (complete information for 143 patients and partial for an additional 22). The mean age of the patients was 68 years; 76 percent had an estimated life expectancy of less than six months. Thirty-five percent requested a prescription from another physician. Twenty-nine patients (18 percent) received prescriptions, and 17 (10 percent) died from taking the prescribed medication. Twenty percent of the patients had symptoms of depression; none of these patients received a prescription for a lethal medication. In the case of 68 patients, including 11 who received prescriptions and 8 who died by taking the prescribed medication, the physician implemented at least one substantive palliative intervention, such as control of pain or other symptoms, referral to a hospice program, a consultation, or a trial of antidepressant medication. Forty-six percent of the patients for whom substantive interventions were made changed their minds about assisted suicide, as compared with 15 percent of those for whom no substantive interventions were made (P<0.001).

Conclusions Our data indicate that in Oregon, physicians grant about 1 in 6 requests for a prescription for a lethal medication and that 1 in 10 requests actually results in suicide. Substantive palliative interventions lead some — but not all — patients to change their minds about assisted suicide.

Source Information

From the Department of Veterans Affairs (L.G., H.D.N., M.A.D.); the Departments of Psychiatry (L.G.), Medicine (H.D.N., M.A.L.), and Emergency Medicine (T.A.S.), the Division of Medical Informatics and Outcomes Research (H.D.N., D.F.K.), and the Center for Ethics in Health Care (L.G., T.A.S.), Oregon Health Sciences University; and the Providence Health System (M.A.L.) — all in Portland, Oreg.

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, or at ganzinil{at}ohsu.edu.

Full Text of this Article

Related Letters:

Physician-Assisted Suicide and Euthanasia
Rasmussen P. A., Hendin H., Rosenfeld B., Breitbart W., Reichel D. W., Manning M. T., Ganzini L., Lee M. A., Schmidt T. A., Groenewoud J. H., van der Heide A., Nuland S. B.
Extract | Full Text  
N Engl J Med 2000; 343:150-153, Jul 13, 2000. Correspondence

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