OREGON EMERGENCY PHYSICIANS EXPERIENCES WITH, ATTITUDES TOWARD, AND CONCERNS ABOUT PHYSICIAN-ASSISTED SUICIDE

Objective: To determine emergency physicians' (EPs') attitudes toward physician-assisted suicide (PAS), factors associated with those attitu des, current experiences with attempted suicides in terminally ill per sons, and concerns about the impact of legalizing PAS on emergency med icine practice. Methods: A cross-sectional, anonymous mailed survey wa s taken of EPs in the state of Oregon. Results: Of 356 eligible physic ians, 248 (70%) returned the survey. Of the respondents, 69% indicated that PAS should be legal, 65% considered PAS consistent with the phys ician's role, and 19% believed that it is immoral. The respondents wer e concerned that patients might feel pressure if they perceived themse lves to be either a care burden on others (82%) or a financial stress to others (69%). Only 37% indicated that the Oregon initiative has eno ugh safeguards to protect vulnerable persons. Support for legalization was not associated with gender, age, or practice location. Respondent s with no religious affiliation were most supportive of PAS (p < 0.001 ), and Catholic respondents were least supportive (p = 0.03). A majori ty (58%) had treated at least 1 terminally ill patient after an appare nt overdose. Most respondents (97%) indicated at least 1 circumstance for which they would sometimes be willing to let a terminally ill pati ent die without resuscitation after PAS if the Oregon initiative becom es law: if verified with an advance directive from the patient (81%), with documentation in writing from the physician (73%), after speaking to the primary physician (64%), if a competent patient verbally confi rmed intent (60%), or if the family verbally confirmed intent (52%). C onclusions: Although the majority of Oregon EPs favor the concept of l egalization of PAS, most have concerns that safeguards in the Oregon i nitiative are inadequate to protect vulnerable patients, These physici ans would consider not resuscitating terminally ill patients who have attempted suicide under the law's provisions, only in the setting of d ocumentation of the patient's intent.