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Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
Attitudes and Practices of Cancer Doctors in the United States regarding Euthanasia and Physician-Assisted Suicide
3 October 2000 | Volume 133 Issue 7 | Page I-39
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician.
The summary below is from the full report titled "Attitudes and Practices of U.S. Oncologists regarding Euthanasia and Physician-Assisted Suicide." It is in the 3 October 2000 issue of Annals of Internal Medicine (volume 133, pages 527-532). The authors are EJ Emanuel, D Fairclough, BC Clarridge, D Blum, E Bruera, WC Penley, LE Schnipper, and RJ Mayer.
What is the problem and what is known about it so far?
In euthanasia, someone ends the life of a sick person at the sick person's request. Physician-assisted suicide involves a sick person ending his or her own life with the help of a doctor. These practices are very controversial in the United States. Because more than 70% of the patients who request euthanasia or physician-assisted suicide have cancer, the attitudes and behaviors of doctors who treat cancer (oncologists) with respect to these practices are of particular interest.
Why did the researchers do this particular study?
To understand better the views and behaviors of American oncologists on euthanasia and physician-assisted suicide.
Who was studied?
3299 American oncologists who were members of the American Society of Clinical Oncology in 1997.
How was the study done?
The researchers asked 6642 oncologists to complete a survey that asked whether they would support euthanasia or physician-assisted suicide for a patient dying of prostate cancer who had severe pain that was not responding to treatment. The survey also asked about requests that these physicians had actually received for euthanasia and physician-assisted suicide and how they had handled those requests.
What did the researchers find?
Of the 6642 oncologists that were approached, 3299 completed the survey. Of these 3299 doctors, 22.5% supported physician-assisted suicide and 6.5% supported euthanasia for the hypothetical patient dying of prostate cancer. Of the doctors who returned the surveys, 62.9% reported that they had received at least one request for euthanasia or physician-assisted suicide during their career; 31.1% had received such a request in the past 12 months. Most of these requests were not fulfilled. During their careers, 3.7% of surveyed doctors had performed euthanasia and 10.8% had participated in physician-assisted suicide at least once. Oncologists who reported problems in getting dying patients all the care they needed were more likely to have performed euthanasia than were those who reported no problems in getting patients adequate end-of-life care.
What were the limitations of the study?
Only 3299 of the 6642 doctors approached completed the survey. The views and practices of doctors who did not participate may differ from those of the doctors who did participate. The accuracy of doctors' responses to surveys on this sensitive issue is not known.
What are the implications of the study?
Doctors in the United States who treat cancer appear to receive a substantial number of requests for euthanasia and physician-assisted suicide. Over 3% of these doctors reported participating in euthanasia and over 10% in physician-assisted suicide. Among the doctors surveyed, those who reported problems with obtaining end-of-life care were more likely to support these practices of helping dying patients to die.
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