PHYSICIAN RESOURCE USE AND WILLINGNESS TO PARTICIPATE IN ASSISTED SUICIDE

Objective: To explore the relationship between general internists' ten dency to conserve medical resources and their willingness to participa te in physician-assisted suicide (PAS). Design and Participant: Survey of a random sample of general internists in 6 urban areas of the Unit ed States. Measurements: We assessed the physicians' use of medical re sources by constructing a scale based on 6 hypothetical clinical scena rios in which respondents were given a choice between resource-intensi ve and resource-conserving options. We then presented a scenario of a competent terminally ill patient with breast cancer making stable and persistent requests for PAS. Results: Sixty-seven (33%) of the 206 res pondents indicated that they would participate in the suicide of the d epicted patient. In a multivariate model, physicians who were more con servative with resources were 6.4 times more likely than their resourc e-intensive counterparts to prescribe the requested drugs (P = .02); m inority physicians were less willing than whites to participate in PAS (odds ratio, 0.34; P = .03). Physicians' number of years in practice, location, sex, reported percentage of fee-for-service patients, and s elf-reported strength and direction of financial incentives in the res pondents' practices were not associated with willingness to prescribe drugs for PAS. Conclusions: Most general internists, especially minori ty physicians, are personally reluctant to participate in PAS. While t he characteristics of their practices do not affect PAS, physicians wh o tend to practice resource-conserving medicine are significantly more likely than their resource-intensive counterparts to provide a lethal prescription at the request of a terminally ill patient.