Predictors of pursuit of physician-assisted death

Kathryn A. Smith, Theresa A Harvath, Elizabeth R. Goy, Linda Ganzini

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Context Physician-assisted death (PAD) was legalized in 1997 by Oregon's Death with Dignity Act. The States of Washington, Montana, Vermont, and New Mexico have since provided legal sanction for PAD. Through 2013, 1173 Oregonians have received a prescription under the Death with Dignity Act and 752 have died after taking the prescribed medication in Oregon. Objectives To determine the predictive value of personal and interpersonal variables in the pursuit of PAD. Methods Fifty-five Oregonians who either requested PAD or contacted a PAD advocacy organization were compared with 39 individuals with advanced disease who did not pursue PAD. We compared the two groups on responses to standardized measures of depression, hopelessness, spirituality, social support, and pain. We also compared the two groups on style of attachment to intimate others and caregivers as understood through attachment theory. Results We found that PAD requesters had higher levels of depression, hopelessness, and dismissive attachment (attachment to others characterized by independence and self-reliance), and lower levels of spirituality. There were moderate correlations among the variables of spirituality, hopelessness, depression, social support, and dismissive attachment. There was a strong correlation between depression and hopelessness. Low spirituality emerged as the strongest predictor of pursuit of PAD in the regression analysis. Conclusion Although some factors motivating pursuit of PAD, such as depression, may be ameliorated by medical interventions, other factors, such as style of attachment and sense of spirituality, are long-standing aspects of the individual that should be supported at the end of life. Practitioners must develop respectful awareness and understanding of the interpersonal and spiritual perspectives of their patients to provide such support.

Original languageEnglish (US)
Pages (from-to)555-561
Number of pages7
JournalJournal of Pain and Symptom Management
Volume49
Issue number3
DOIs
StatePublished - Mar 1 2015

Fingerprint

Assisted Suicide
Spirituality
Physicians
Depression
Right to Die
Social Support
Caregivers
Prescriptions
Regression Analysis
Organizations
Pain

Keywords

  • attachment
  • depression
  • end-of-life care
  • euthanasia
  • hopelessness
  • pain
  • Physician-assisted death
  • spirituality

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology
  • Nursing(all)
  • Medicine(all)

Cite this

Predictors of pursuit of physician-assisted death. / Smith, Kathryn A.; Harvath, Theresa A; Goy, Elizabeth R.; Ganzini, Linda.

In: Journal of Pain and Symptom Management, Vol. 49, No. 3, 01.03.2015, p. 555-561.

Research output: Contribution to journalArticle

Smith, Kathryn A. ; Harvath, Theresa A ; Goy, Elizabeth R. ; Ganzini, Linda. / Predictors of pursuit of physician-assisted death. In: Journal of Pain and Symptom Management. 2015 ; Vol. 49, No. 3. pp. 555-561.
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