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New Data on Physician-Assisted Suicide and Euthanasia

Three studies provide new perspectives on assisted suicide and euthanasia in the Netherlands and the U.S.

Dutch researchers interviewed physicians involved in euthanasia (intended in 535 cases) or physician-assisted suicide (intended in 114). Technical problems (e.g., difficulty finding a vein for injection, difficulty giving an oral drug) occurred in 5 percent of cases, complications (e.g., spasms, vomiting) in 4 percent, and problems with completion (e.g., longer than expected time to death, patient awakening from coma) in 7 percent. These problems occurred more frequently with assisted suicide than with euthanasia and led to administration of a lethal medication in 18 percent of assisted suicide cases (thus converting these cases into euthanasia).

In a survey of physicians in Oregon (the only U.S. state where assisted suicide is legal), 5 percent of 2649 physicians reported that they had received 1 or more requests for lethal prescriptions between late 1997 and early 1999. Most patients had cancer and a life expectancy of less than 6 months. In 30 percent of the cases, interventions such as pain control and hospice referral changed the patient's mind about assisted suicide. Of 165 patients for whom respondents reported the outcome of a request, 29 received prescriptions, and 17 died after taking the medication.

Finally, Oregon physicians are required to notify the Oregon Health Division when they have prescribed lethal medication. The Division was notified of 33 such cases in 1999; 27 patients died after taking the medication, up from 16 in 1998.

Comment: The Dutch experience suggests that euthanasia and assisted suicide do not always proceed uneventfully, and points to a need for immediate physician availability in these cases. The Oregon data imply that assisted suicide is not increasing dramatically in that state, although there may be underreporting.

— AS Brett

Published in Journal Watch General Medicine March 10, 2000

Citation(s):

Groenewoud JH et al. Clinical problems with the performance of euthanasia and physician-assisted suicide in the Netherlands. N Engl J Med 2000 Feb 24 342 551-556.

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• Medline abstract (Free)

Ganzini L et al. Physicians' experiences with the Oregon Death with Dignity Act. N Engl J Med 2000 Feb 24 342 557-563.

• Original article (Subscription may be required)
• Medline abstract (Free)

Sullivan AD et al. Legalized physician-assisted suicide in Oregon -- The second year. N Engl J Med 2000 Feb 24 342 598-604.

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• Medline abstract (Free)