Attitudes and practices of U.S. oncologists regarding euthanasia and physician-assisted suicide

Ann Intern Med. 2000 Oct 3;133(7):527-32. doi: 10.7326/0003-4819-133-7-200010030-00011.

Abstract

Background: The practices of euthanasia and physician-assisted suicide remain controversial.

Objective: To achieve better understanding of attitudes and practices regarding euthanasia and physician-assisted suicide in the context of end-of-life care.

Design: Cohort study.

Setting: United States.

Participants: 3299 oncologists who are members of the American Society of Clinical Oncology.

Measurements: Responses to survey questions on attitudes toward euthanasia and physician-assisted suicide for a terminally ill patient with prostate cancer who has unremitting pain, requests for and performance of euthanasia and physician-assisted suicide, and sociodemographic characteristics.

Results: Of U.S. oncologists surveyed, 22.5% supported the use of physician-assisted suicide for a terminally ill patient with unremitting pain and 6.5% supported euthanasia. Oncologists who were reluctant to increase the dose of intravenous morphine for terminally ill patients in excruciating pain (odds ratio [OR], 0.61 [95% CI, 0.48 to 0.77]) and had sufficient time to talk to dying patients about end-of-life care issues (OR, 0.79 [CI, 0.71 to 0.87]) were less likely to support euthanasia or physician-assisted suicide. During their career, 3.7% of surveyed oncologists had performed euthanasia and 10.8% had performed physician-assisted suicide. Oncologists who were reluctant to increase the morphine dose for patients in excruciating pain (OR, 0.58 [CI, 0.43 to 0.79]) and those who believed that they had received adequate training in end-of-life care (OR, 0.86 [CI, 0.79 to 0.95]) were less likely to have performed euthanasia or physician-assisted suicide. Oncologists who reported not being able to obtain all the care that a dying patient needed were more likely to have performed euthanasia (P = 0.001).

Conclusions: Requests for euthanasia and physician-assisted suicide are likely to decrease as training in end-of-life care improves and the ability of physicians to provide this care to their patients is enhanced.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / therapeutic use
  • Cohort Studies
  • Euthanasia*
  • Euthanasia, Active, Voluntary*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Medical Oncology*
  • Middle Aged
  • Morphine / therapeutic use
  • Pain, Intractable / drug therapy
  • Prostatic Neoplasms / physiopathology
  • Regression Analysis
  • Suicide, Assisted*
  • Surveys and Questionnaires
  • United States

Substances

  • Analgesics, Opioid
  • Morphine