PHYSICIAN-ASSISTED SUICIDE AND PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE

Background Data are limited on the attitudes and practices of physicia ns regarding assisting the suicide of patients with human immunodefici ency virus (HIV) disease. Methods Between November 1994 and January 19 95, we used an anonymous, self-administered questionnaire to survey al l 228 physicians in the Community Consortium, an association of provid ers of health care to patients infected with HIV in the San Francisco Bay area. The responses were compared with those in a 1990 survey of c onsortium physicians. Physician-assisted suicide was defined as ''a ph ysician providing a sufficient dose of narcotics to enable a patient t o kill himself.'' Respondents were to ''assume that the patient is a m entally competent, severely ill individual facing imminent death.'' Re sults One hundred eighteen of the questionnaires were evaluated. Respo ndents reported a mean of 7.9 ''direct'' and 13.7 ''indirect'' request s from patients for assistance. In responses based on a case vignette, 48 percent of the physicians said they would be likely or very likely to grant the request of a patient with the acquired immunodeficiency syndrome (AIDS) for assistance in a suicide, as compared with 28 perce nt of the respondents in 1990. Asked to estimate the number of times t hey had granted the request of a patient with AIDS for assistance in c ommitting suicide, 53 percent said they had done so at least once (mea n number of times, 4.2; median, 1.0; range, 0 to 100). In a multivaria te analysis, factors positively associated with a physician's having, in fact, assisted a suicide were having had a higher number of patient s with AIDS who had died; having received a higher number of indirect requests from patients for assistance; having a stated gay, lesbian, o r bisexual orientation him- or herself; and having a higher ''intentio n to assist'' score (as calculated from the physician's responses to t he case vignette). Conclusions Within a group of physicians caring for patients with HIV disease, the acceptance of assisted suicide increas ed between 1990 and 1995. A majority of respondents in 1995 said they had granted a request for assisted suicide from a patient with AIDS at least once. (C) 1997, Massachusetts Medical Society.