Study Documents Attitudes About Assisted Suicide Among Patients With Lou Gehrig's Disease

October 01, 1998

First Study To Document Oregon Patients' Attitudes About Physician-Assisted Suicide

(Portland, OR) -- Research being published in the October 1 edition of the New England Journal of Medicine provides the first scientific documentation of an Oregon patient group's attitudes towards physician-assisted suicide. Between 1995 and 1997 researchers interviewed 100 patients with amyotrophic lateral sclerosis (Lou Gehrig's disease), a neuromuscular disease that causes gradual paralysis, respiratory failure and death, usually within three to five years after diagnosis. The research also explored caregiver attitudes about assisted suicide.

The majority (56 percent) of the patients interviewed said they would consider assisted suicide. Forty-four of the 56 agreed with the statement, "If physician-assisted suicide were legal, I would request a lethal prescription from a physician." (note: The research was completed before the defeat of Measure 51 in November, 1997, which allowed Oregon's Death With Dignity Act to take effect).

While A.L.S. gradually robs patients of neuromuscular function, many patients do not experience intense physical pain. "For many of these patients, interest in assisted suicide was not associated with current suffering but fears of future suffering," said Linda Ganzini, M.D., associate professor of psychiatry at OHSU, director of geriatric psychiatry at the Portland Veterans Affairs Medical Center and lead author of the study. Of the 44 patients who said they would request a lethal prescription, 36 said they would "probably keep the prescription available to potentially use in the future."

"Perhaps the more interesting result is that neither disease duration, depression, nor self-reported levels of disability, pain and suffering differed significantly between the group that would consider assisted suicide and those who would not," said Wendy Johnston, M.D., director of the A.L.S. clinic in OHSU's Department of Neurology and a co-author of the study. "Whereas hopelessness about the future and a lower quality of life were correlated with a desire to hasten death. So how an individual is dealing with A.L.S. seems more important than the physical impact of the disease."

"For many of these patients, there's a gap between wanting a lethal prescription available and actually wanting to end one's life," said Ganzini. "That's where health care personnel need to step in and find out what the patient's request really means. There could be ways to help these patients focus more on the present and less on future fears and the worst outcomes."

The study also probed family caregivers' attitudes about assisted suicide. In 73 percent of cases, caregivers and patients had the same attitude on the subject. Caring for a patient with A.L.S. required a significant commitment of time and energy. Support ranged from providing assistance with shopping to helping the patient bathe and use the toilet. Thirty-seven percent of caregivers lost income because of caregiving: 23 percent reported their social lives suffered frequently: 20 percent said they frequently did not have enough time for themselves: 33 percent said they frequently felt stressed because of caring for the patient. Nearly a quarter of caregivers were clinically depressed. None of these factors was associated with the caregiver's attitude towards assisted suicide. Patients and families with strong religious beliefs and frequent religious practices were much less likely to consider assisted suicide than those who were less religious.

"What emerges from this study is that A.L.S. patient attitudes about assisted suicide are related to both who they are and how they are dealing with the disease," said Johnston. "With physician-assisted suicide a reality in Oregon we think more of this kind of work is necessary to help health care providers understand what prompts someone to ask for a lethal prescription."

Oregon Health & Science University

Related Amyotrophic Lateral Sclerosis Articles from Brightsurf:

Converting lateral scanning into axial focusing to speed up 3D microscopy
In optical microscopy, high-speed volumetric imaging is limited by either the slow axial scanning rate or aberrations introduced by the z-scanning mechanism.

Ammonium triggers formation of lateral roots
Despite the importance of changes in root architecture to exploit local nutrient patches, mechanisms integrating external nutrient signals into the root developmental program remain poorly understood.

'Reelin' in a new treatment for multiple sclerosis
In an animal model of multiple sclerosis (MS), decreasing the amount of a protein made in the liver significantly protected against development of the disease's characteristic symptoms and promoted recovery in symptomatic animals, UTSW scientists report.

Adjustable lordotic expandable vs static lateral lumbar interbody fusion devices
The objective of this study is to compare the clinical and radiographic outcomes between patients treated with static and expandable interbody spacers with adjustable lordosis for MIS LLIF.

Chirality-assisted lateral momentum transfer for bidirectional enantioselective separation
Chiral nanoparticles which twist the light were theoretically predicted to experience lateral forces perpendicular to light vector but lacks experimental verification.

Not all multiple sclerosis-like diseases are alike
Scientists say some myelin-damaging disorders have a distinctive pathology that groups them into a unique disease entity.

Researchers delay onset of amyotrophic lateral sclerosis (ALS) in laboratory models
Scientists have delayed the onset of amyotrophic lateral sclerosis (ALS) in laboratory models, leaving them cautiously optimistic that the result, combined with other clinical advances, points to a potential treatment for ALS in humans.

Emerging role of adenosine in brain disorders and amyotrophic lateral sclerosis
The role of adenosine in neurodegeneration and neuroregeneration has led to growing attention on adenosine receptors as potential drug targets in a range of brain disorders, including neuroregenerative therapy and treatment for amyotrophyic lateral sclerosis (ALS).

New clues about the origins of familial forms of Amyotrophic lateral sclerosis
A Brazilian study made important progress in understanding the accumulation of one of the proteins involved in amyotrophic lateral sclerosis (ALS).

Recrutement of a lateral root developmental pathway into root nodule formation of legumes
Peas and other legumes develop spherical or cylindrical structures -- called nodules -- in their roots to establish a mutually beneficial relationship with bacteria that convert atmospheric nitrogen into a useable nutrient for the legume plant.

Read More: Amyotrophic Lateral Sclerosis News and Amyotrophic Lateral Sclerosis Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to