End-of-Life Choice, Palliative Care and Counseling

Posts TaggedJournal of Pain and Symptom Management

Dying: Study Tracks Kin of Those Using Death With Dignity

By Don Colburn, The Oregonian, September 30, 2009

Family members of Oregonians who seek to end their lives with a drug overdose prescribed under the Death With Dignity Act are no more likely than other survivors to suffer prolonged grief or depression, a new study reports.

“In summary, pursuit of physician aid in dying does not appear to have a negative effect on surviving family members and, in fact, may help some family members prepare for death,” the study concluded.

The study is by a team of researchers from the Portland Veterans Affairs Medical Center and Oregon Health & Science University. They posted their findings online this week in the Journal of Pain and Symptom Management.

One possible explanation for their results, researchers suggested, is that “when patients bring up the option of physician-assisted death, family members’ denial is diminished and they are pushed to accelerate grieving and resolve grief.”

The study surveyed and compared two groups of surviving family members. One group included 95 relatives of Oregonians who sought a lethal prescription under the Oregon law. The other group included 63 family members of Oregonians who died of cancer or amyotrophic lateral sclerosis (ALS) without seeking a life-ending drug.

The rates of grief and depression were nearly identical among the two groups of family survivors. But family members of people who requested a lethal prescription indicated they felt more prepared for and more accepting of the death, said Dr. Linda Ganzini, a psychiatrist at the Portland VA and OHSU, and lead author of the study.

“Among the 36 family members whose loved one chose physician-assisted death, only two felt rejected by the choice,” the study found. One in four had difficulty talking about the death — about the same as in the comparison group.

It is the first such study of mental health outcomes in family members of patients who request and receive aid from a doctor in dying under the Death With Dignity Act.

Oregon and Washington are the only states where it is legal for a doctor to prescribe a lethal drug overdose to a terminally ill patient of sound mind who requests it orally and in writing. About 400 Oregonians died this way during the first 11 years of the Oregon Death With Dignity Act.

Advocates of the Oregon law say it allows terminally ill patients to control the circumstances and timing of an impending death. Opponents call the practice doctorassisted suicide and say it undercuts the physician’s Hippocratic duty to “first, do no harm.”

Of the study’s 95 family members whose loved ones requested aid in dying, 59 had a relative who received a lethal prescription under the law and, of those who received the drugs, 36 had a relative who died that way.

The research was funded by the Greenwall Foundation.

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