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Original Investigation
July 14, 2003

Characteristics of Patients Requesting and Receiving Physician-Assisted Death

Author Affiliations

From the Hertzberg Palliative Care Institute, Department of Geriatrics and Adult Development (Drs Meier and Morrison and Ms Litke) and Department of Biomathematical Sciences (Dr Wallenstein), Mount Sinai School of Medicine, New York, NY; and National Opinion Research Center, Chicago, Ill (Dr Emmons). The authors have no relevant financial interest in this article.

Arch Intern Med. 2003;163(13):1537-1542. doi:10.1001/archinte.163.13.1537

Background  Surveys have shown that physicians in the United States report both receiving and honoring requests for physician assistance with a hastened death. The characteristics of patients requesting and receiving physician aid in dying are important to the development of public policy.

Objective  To determine patient characteristics associated with acts of physician-assisted suicide.

Design  Physicians among specialties involved in care of the seriously ill and responding to a national representative prevalence survey on physician-assisted suicide and euthanasia were asked to describe the demographic and illness characteristics of the most recent patient whose request for assisted dying they refused as well as the most recent request honored.

Results  Of 1902 respondents (63% of those surveyed), 379 described 415 instances of their most recent request refused and 80 instances of the most recent request honored. Patients requesting assistance were seriously ill, near death, and had a significant burden of pain and physical discomfort. Nearly half were described as depressed at the time of the request. The majority made the request themselves, along with family. In multivariate analysis, physicians were more likely to honor requests from patients making a specific request who were in severe pain (odds ratio, 2.4; 95% confidence interval, 1.01-5.7) or discomfort (odds ratio, 6.5; 95% confidence interval, 2.6-16.1), had a life expectancy of less than 1 month (odds ratio, 4.3; 95% confidence interval, 1.7-10.8), and were not believed to be depressed at the time of the request (odds ratio, 0.2; 95% confidence interval, 0.1-0.5).

Conclusion  Persons requesting and receiving assistance in dying are seriously ill with little time to live and a high burden of physical suffering.