Desire for euthanasia or physician-assisted suicide in palliative cancer care
Institute for Rehabilitation Research and Development, The Rehabilitation Centre, The Ottawa Hospital, Ottawa, ON, and Department of Psychiatry, University of Manitoba, Winnipeg, Canada. Health Psychology
(Impact Factor: 3.59).
06/2007; 26(3):314-23. DOI: 10.1037/0278-622.214.171.1244
To investigate the attitudes of terminally ill individuals toward the legalization of euthanasia or physician-assisted suicide (PAS) and to identify those who would personally desire such a death.
In the Canadian National Palliative Care Survey, semistructured interviews were administered to 379 patients who were receiving palliative care for cancer. Patients who expressed a desire for physician-hastened death were followed prospectively.
Attitudes toward the legalization of euthanasia or PAS were determined, as was the personal interest in receiving a hastened death. Demographic and clinical characteristics were also recorded, including a 22-item structured interview of symptoms and concerns.
There were 238 participants (62.8%) who believed that euthanasia and/or PAS should be legalized, and 151 (39.8%) who would consider making a future request for a physician-hastened death. However, only 22 (5.8%) reported that, if legally permissible, they would initiate such a request right away, in their current situations. This desire for hastened death was associated with lower religiosity (p=.010), reduced functional status (p=.024), a diagnosis of major depression (p<.001), and greater distress on 12 of 22 individual symptoms and concerns (p<.025). In follow-up interviews with 17 participants, 2 (11.8%) showed instability in their expressed desire.
Among patients receiving palliative care for cancer, the desire to receive euthanasia or PAS is associated with religious beliefs; functional status; and physical, social, and psychological symptoms and concerns. Although this desire is sometimes transitory, once firmly established, it can be enduring.
Available from: Norbert Köhler
- "). Darüber hinaus konnte gezeigt werden, dass etwa zehn Prozent der verstorbenen Krebspatienten am Lebensende den Wunsch nach aktiver Sterbehilfe äußerten. Damit liegt die ermittelte Prävalenz tatsächlich geäußerter Wünsche nach Sterbehilfe im mittleren Bereich bisher durchgeführter Studien, die in unterschiedlichen Settings Prävalenzraten zwischen sechs und zwanzig Prozent ermittelten (Pardon et al. 2012; Wilson et al. 2007). Auch die im Rahmen der vorliegenden Studie deutlich werdende große Bedeutung psychischer Ursachen wird durch einen 35 Einzelstudien umfassenden systematischen Review bestätigt (Hudson et al. 2006). "
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ABSTRACT: Background: It is a matter of debate whether euthanasia should be part of medical practice.
Objectives: The current study investigates the attitudes of bereaved family members of cancer
patients towards euthanasia.
Materials and methods: We conducted a survey with 211 people who had recently lost a close
relative to cancer. Participants were asked whether euthanasia should be part of medical prac-
tice. Two logistic regression models were calculated in order to determine the factors influenc-
ing the attitude towards active euthanasia and assisted suicide.
Results: About 70 % and 75 % of the respondents approved active euthanasia and assisted
suicide, respectively. Religious denomination and psychological distress had a significant im-
pact on the attitude towards active euthanasia. About 10 % of the deceased patients had asked
for active euthanasia.
Conclusions: There was no difference between bereaved family members and the general po-
pulation regarding the acceptance of euthanasia. Attitudes towards active euthanasia are asso-
ciated with psychological distress and shaped by cultural values rather than by the experience
of end-of-life care.
Available from: Katherine Péloquin
- "SPB may be higher among those with other disabling but nonfatal conditions, such as stroke . SPB is associated with physical symptoms (eg, pain and physical weakness) and, more robustly, with psychological difficulties (eg, depression, anxiety, and decreased quality of life)      , all of which are pertinent to the experience of chronic pain. "
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ABSTRACT: Chronic pain is a debilitating condition that can have an impact on various facets of interpersonal functioning. Although some studies have examined the extent to which family members are affected by an individual's chronic pain, none have examined patients' perceptions of feeling that they have become a burden to others. Research on self-perceived burden in different medical populations, such as cancer, amyotrophic lateral sclerosis, and stroke, has shown that it is associated with physical symptoms and, more robustly, with psychological difficulties and concerns. The present study examined the prevalence and predictors of self-perceived burden in a tertiary chronic pain sample. Participants were consecutive patients (N = 238) admitted to an outpatient, interdisciplinary, chronic pain management program at a rehabilitation hospital. At admission, participants completed a battery of psychometric questionnaires assessing self-perceived burden, as well as a number of clinically relevant constructs. Their significant others (n = 80) also completed a measure of caregiver burden. Self-perceived burden was a commonly reported experience among chronic pain patients, with more than 70% of participants endorsing clinically elevated levels. It was significantly correlated with pain intensity ratings, functional limitations, depressive symptoms, attachment anxiety, pain self-efficacy, and caregiver burden. Self-perceived burden was also correlated with an item assessing suicidal ideation. In a hierarchical regression model, depressive symptoms, pain self-efficacy, and adult attachment significantly predicted self-perceived burden after controlling for demographic and pain-related variables. In conclusion, self-perceived burden is a clinically relevant and commonly reported interpersonal experience in patients with longstanding pain.
Available from: Gary Rodin
- "This term was used to refer to the discordance between the actual poor health status of disabled individuals and their positive ratings of quality of life and life satisfaction. This observation was confirmed in a study by Wilson et al. (2007) in which almost half of cancer patients in palliative care did not consider themselves to be suffering, and a quarter of them believed that their suffering was only mild. Our study suggests that this paradox may arise from the explicit goal of valuing life in the present, reinforced by the mental strategies of positive comparisons and conservative planning. "
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ABSTRACT: A longitudinal qualitative research study was undertaken to provide an understanding of a prolonged experience of advanced cancer, as seen through the eyes of dying individuals. Using a variant of the grounded theory method, the authors theoretically sampled, from outpatient clinics in a large comprehensive cancer treatment center, 27 patients with either advanced lung or gastrointestinal cancer who had an expected survival of up to 2 years. The authors conducted a total of 54 interviews with these patients to learn of their experience of advanced cancer. The authors represent their experience with the core category: striving to grow in the land of the living/dying, symbolizing their sense of finding themselves in a borderland between life and death where their efforts focused on 3 common goals. controlling dying, valuing life in the present, and creating a living legacy. They provide a longitudinal account of how these goals were addressed throughout the illness trajectory and discuss the theoretical and clinical implications of this understanding for the experience of dying from advanced cancer.
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