Attitudes of terminally ill patients toward euthanasia and physician-assisted suicide

Background: In jurisdictions that permit euthanasia or physician-assisted s uicide, patients with cancer comprise the largest group to die by these met hods. We investigated the personal attitudes toward these practices of pati ents receiving palliative care for advanced cancer. Methods: Seventy patients (32 men and 38 women; median survival, 44.5 days) took part in a survey using in-depth semistructured interviews. The interv iews were audiotaped for transcription and content analysis of themes. Results: Most participants (73%) believed that euthanasia or physician-assi sted suicide should be legalized, citing pain and the individual's right to choose as their major reasons. Participants who were opposed to legalizati on cited religious and moral objections as their central concerns. Forty (5 8%) of the 69 participants who completed the entire interview also believed that, if legal, they might personally make a future request for a hastened death, particularly if pain or physical symptoms became intolerable. Eight of these individuals (12%) would have made such a request at the time of t he interview. These 8 participants differed from all others on ratings of l oss of interest or pleasure in activities, hopelessness, and the desire to die (Ps<.02). They also had a higher prevalence of depressive disorders (P< .05). However, they did not differ on ratings of pain severity. Conclusions: Many patients with advanced cancer favor policies that would a llow them access to both euthanasia and physician-assisted suicide if pain and physical symptoms became intolerable. For patients who would actually m ake requests for a physician-hastened death, however, psychological conside rations may be at least as salient as physical symptoms.