 |
|
Oregon Physicians' Attitudes About and Experiences With End-of-Life Care Since Passage of the Oregon Death with Dignity Act
Linda Ganzini, MD;
Heidi D. Nelson, MD,MPH;
Melinda A. Lee, MD;
Dale F. Kraemer, PhD;
Terri A. Schmidt, MD;
Molly A. Delorit, BA
JAMA. 2001;285:2363-2369.
Context The Oregon Death with Dignity Act, passed by ballot measure in 1994 and enacted in October 1997, legalized physician-assisted suicide for competent, terminally ill Oregonians, but little is known about the effects of the act on clinical practice or physician perspective.
Objective To examine Oregon physicians' attitudes toward and practices regarding care of dying patients since the passage of the Death with Dignity Act.
Design, Setting, and Participants A self-administered questionnaire was mailed in February 1999 to Oregon physicians eligible to prescribe under the act. Of 3981 eligible physicians, 2641 (66%) returned the questionnaire by August 1999.
Main Outcome Measures Physicians' reports of their efforts to improve care for dying patients since 1994, their attitudes, concerns, and sources of information about participating in the Death with Dignity Act, and their conversations with patients regarding assisted suicide.
Results A total of 791 respondents (30%) reported that they had increased referrals to hospice. Of the 2094 respondents who cared for terminally ill patients, 76% reported that they made efforts to improve their knowledge of the use of pain medications in the terminally ill. Nine hundred forty-nine responding physicians (36%) had been asked by a patient if they were potentially willing to prescribe a lethal medication. Seven percent of all survey participants reported that 1 or more patients became upset after learning the physician's position on assisted suicide, and 2% reported that 1 or more patients left their care after learning the physician's position on assisted suicide. Of the 73 physicians who were willing to write a lethal prescription and who had received a request from a patient, 20 (27%) were not confident they could determine when a patient had less than 6 months to live.
Conclusion Most Oregon physicians who care for terminally ill patients report that since 1994 they have made efforts to improve their ability to care for these patients and many have had conversations with patients about assisted suicide.
Author Affiliations: Department of Veterans Affairs, Portland, Ore (Drs Ganzini and Nelson and Ms Delorit); Departments of Psychiatry (Dr Ganzini), Medicine (Drs Nelson and Lee), Emergency Medicine (Dr Schmidt), Division of Medical Informatics and Outcomes Research (Drs Nelson and Kraemer), and the Center for Ethics in Health Care (Drs Ganzini and Schmidt), Oregon Health Sciences University, Portland; and the Providence Health System (Dr Lee), Portland.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED LETTER
Patient-Physician Discussions About Physician-Assisted Suicide
Lauris C. Kaldjian, Linda Ganzini, Dale F. Kraemer, Melinda A. Lee, and Terri A. Schmidt
JAMA. 2001;286(7):788-789.
EXTRACT
| FULL TEXT
RELATED ARTICLE
May 9, 2001
JAMA. 2001;285(18):2393-2394.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Judgement of suffering in the case of a euthanasia request in The Netherlands
Rietjens et al.
J. Med. Ethics 2009;35:502-507.
ABSTRACT
| FULL TEXT
Collaborated Death: An Exploration of the Swiss Model of Assisted Suicide for Its Potential to Enhance Oversight and Demedicalize the Dying Process
Ziegler
J Law Med Ethics 2009;37:318-330.
On "Distinguishing Among Irrational Suicide, Rational Suicide, and Other Forms of Hastened Death: Implications for Clinical Practice" by Cavin P. Leeman, M.D
Hicks
Psychosomatics 2009;50:194-195.
FULL TEXT
Physician-assisted suicide: a survey of attitudes among Swedish physicians
Lindblad et al.
Scand J Public Health 2008;36:720-727.
ABSTRACT
The case for physician assisted suicide: how can it possibly be proven?
Dahl and Levy
J. Med. Ethics 2006;32:335-338.
ABSTRACT
| FULL TEXT
The impact on patient trust of legalising physician aid in dying
Hall et al.
J. Med. Ethics 2005;31:693-697.
ABSTRACT
| FULL TEXT
Legalised euthanasia will violate the rights of vulnerable patients
George et al.
BMJ 2005;331:684-685.
FULL TEXT
Physician-Assisted Suicide -- Oregon and Beyond
Okie
NEJM 2005;352:1627-1630.
FULL TEXT
Attitudes and experiences of Oregon hospice nurses and social workers regarding assisted suicide
Miller et al.
Palliat Med 2004;18:685-691.
ABSTRACT
"Underground Euthanasia" and the Harm Minimization Debate
Magnusson
J Law Med Ethics 2004;32:486-495.
Dying with dignity: The good patient versus the good death
Proulx and Jacelon
AM J HOSP PALLIAT CARE 2004;21:116-120.
ABSTRACT
Characteristics of Patients Requesting and Receiving Physician-Assisted Death
Meier et al.
Arch Intern Med 2003;163:1537-1542.
ABSTRACT
| FULL TEXT
The Legal and Political Future of Physician-Assisted Suicide
Palmer
JAMA 2003;289:2283-2283.
FULL TEXT
Professional Organizations' Position Statements on Physician-Assisted Suicide: A Case for Studied Neutrality
Quill and Cassel
ANN INTERN MED 2003;138:208-211.
ABSTRACT
| FULL TEXT
Older Persons' Ethical Problems Involving Their Health
Cameron
Nurs Ethics 2002;9:537-556.
ABSTRACT
Physician-Assisted Suicide
Leeman
ANN INTERN MED 2002;137:216-216.
FULL TEXT
Responding to Requests for Physician-Assisted Suicide: "These Are Uncharted Waters for Both of Us. . . ."
Bascom and Tolle
JAMA 2002;288:91-98.
ABSTRACT
| FULL TEXT
Physician-Assisted Suicide in Oregon -- An Uncertain Future
Steinbrook
NEJM 2002;346:460-464.
FULL TEXT
Patient-Physician Discussions About Physician-Assisted Suicide
Kaldjian et al.
JAMA 2001;286:788-789.
FULL TEXT
|
