ATTITUDES OF PATIENTS WITH AMYOTROPHIC-LATERAL-SCLEROSIS AND THEIR CARE GIVERS TOWARD ASSISTED SUICIDE

Background and Methods Amyotrophic lateral sclerosis (ALS) is a neurom uscular disease that causes gradual paralysis, respiratory failure, an d death, usually within three to five years after it has been diagnose d. Between 1995 and 1997, we surveyed patients with this disease in Or egon and Washington, as well as their family care givers, in order to determine their attitudes toward assisted suicide. Patients were consi dered to be willing to contemplate assisted suicide if they agreed wit h the statement, ''Under some circumstances I would consider taking a prescription for a medicine whose sole purpose was to end my life,'' a nd disagreed with the statement, ''I would never request or take a pre scription for a medication whose sole purpose was to end my life.'' Th e Oregon Death with Dignity Act, which legalized physician-assisted su icide, was approved by Oregon voters in 1994 but did not go into effec t until October 1997, after data collection for this study had been co mpleted. Results Of 140 eligible persons with ALS, 100 (71 percent) ag reed to participate in the study, as did 91 family care givers. The me an age of the patients with ALS was 54 years; the mean duration of ill ness since the diagnosis was 2.8 years. Fifty-six patients (56 percent ) said they would consider assisted suicide, and 44 of the 56 agreed w ith the statement, ''If physician-assisted suicide were legal, I would request a lethal prescription from a physician.'' One patient would h ave taken the medication immediately, and 36 would have kept it for fu ture use. As compared with the patients who were opposed to assisted s uicide, those who would consider it were mure likely to be men, had a higher level of education, were less likely to be religious, had highe r scores for hopelessness, and rated their quality of life as lower. I n 66 of 91 instances (73 percent), care givers and patients had the sa me attitude toward assisted suicide. Conclusions In Oregon and Washing ton, a majority of persons with ALS whom we surveyed would consider as sisted suicide. Many would request a prescription for a lethal dose of medication well before they intended to use it. (N Engl J Med 1998;33 9: 967-73.) (C)1998, Massachusetts Medical Society.