Medical Ethics: Physician-assisted suicide survey, WP, April 1998

By Daniel Q. Haney Associated Press
Washington Post, Thursday, April 23, 1998; Page A09

BOSTON, April 22--The first national survey of physician-assisted suicide found that 6 percent of the front-line doctors who responded have hastened patients' deaths with lethal injections or prescriptions.

The results suggest that while physician-assisted suicide does occur, it is rare and accounts for a small number of deaths in the United States.

The survey was conducted in 1996, a year before Oregon became the first state to legalize doctor-assisted suicide. Physicians there can prescribe lethal drugs at the request of patients who have less than six months to live.

Diane E. Meier of Mount Sinai School of Medicine in New York City sent questionnaires to 3,102 doctors; 1,902 answered anonymously. The results appear in the New England Journal of Medicine being published Thursday.

The survey asked family practitioners, general internists, cardiologists and others who regularly care for the dying whether they had ever given lethal injections or had written prescriptions so patients could kill themselves.

Eighteen percent said they had received such requests. Five percent said they had given at least one lethal injection, and 3 percent had written a prescription; some had done both. Overall about 6 percent said they had done one or the other.

The doctors said most of the patients asked for help ending their lives because of discomfort, pain, loss of dignity and fear of uncontrollable symptoms.

Most physicians who had intentionally hastened a patient's death said they had done so only once or twice. However, one reported writing 25 prescriptions and giving 150 lethal injections.

Among other findings:

One-third of doctors said they would write prescriptions for deadly doses and one-quarter would give lethal injections if they were legal.

Of the 10 specialties surveyed, general internists and those who specialize in care of the elderly and lung problems were most likely to help hasten patients' deaths.

Opiates such as morphine were the drugs most often given to help patients die.

"There is good reason to think this actually characterizes the behavior of doctors nationwide, and this is the first time we have ever had that," said Joanne Lynn, president of Americans for Better Care of the Dying, an advocacy group.

While this is the first national survey of a broad range of physicians, about 30 earlier ones have surveyed doctors in particular specialties or geographic areas. Ezekiel Emanuel of the National Institutes of Health, who has surveyed cancer specialists, said these studies found that between 3 and 13 percent of doctors report assisting patients in suicide.

"It is not common, and if they do it, they don't do it a lot," he said.

Emanuel estimated that perhaps 1 percent of all patient deaths are hastened by physicians.

© Copyright 1998 The Associated Press