TY  - JOUR
T1  - ORegonians' reasons for requesting physician aid in dying
AU  - Ganzini L, Goy ER, Dobscha SK
Y1  - 2009/03/09
N1  - 10.1001/archinternmed.2008.579
JO  - Archives of Internal Medicine
SP  - 489
EP  - 492
VL  - 169
IS  - 5
N2  - Background 
    Oregon is the only US jurisdiction with a legal process, the Oregon Death with Dignity Act, that allows terminally ill patients to obtain physician aid in dying (PAD).Methods 
    Fifty-six Oregonians who either requested PAD or contacted a PAD advocacy organization completed a survey indicating the importance of 29 reasons for their interest in PAD on a scale where 1 was not important and 5 was very important; 28% of people referred from the PAD advocacy organization enrolled in the study.Results 
    Forty-one patients died by the end of the study; 18 received a prescription for medication under the Oregon Death with Dignity Act, and 9 died by lethal dose of medication. The most important reasons for requesting PAD, all with median scores of 5, were wanting to control the circumstances of death and die at home; loss of independence; and concerns about future pain, poor quality of life, and inability to care for one's self. All physical symptoms (eg, pain, dyspnea, and fatigue) at the time of the interview were rated as unimportant (median score, 1), but concerns about physical symptoms in the future were rated at a median score of 3 or higher. Lack of social support and depressed mood were rated as unimportant reasons for requesting PAD.Conclusions 
    At the time they express initial interest in PAD, Oregonians are motivated by worries about future physical discomfort and losses of autonomy and function. When confronted with a request for PAD, health care providers should first work to bolster the patient's sense of control and to educate and reassure the patient regarding management of future symptoms.
SN  - 0003-9926
M3  - doi: 10.1001/archinternmed.2008.579
UR  - http://dx.doi.org/10.1001/archinternmed.2008.579
ER  -