Attitudes and practices of US oncologists regarding euthanasia and physician-assisted suicide

Background: The practices of euthanasia and physician-assisted suicide rema in controversial. Objective: To achieve better understanding of attitudes and practices regar ding euthanasia and physician-assisted suicide in the context of end-of-lif e care. Design: Cohort study. Setting: United States. Participants: 3299 oncologists who are members of the American Society of C linical Oncology. Measurements: Responses to survey questions on attitudes toward euthanasia and physician-assisted suicide for a terminally ill patient with prostate c ancer who has unremitting pain, requests for and performance of euthanasia and physician-assisted suicide, and sociodemographic characteristics. Results: Of U.S. oncologists surveyed, 22.5% supported the use of physician -assisted suicide for a terminally ill patient with unremitting pain and 6. 5% supported euthanasia Oncologists who were reluctant to increase the dose of intravenous morphine for terminally ill patients in excruciating pain ( odds ratio [OR], 0.61 [95% CI, 0.48 to 0.77]) and had sufficient time to ta lk to dying patients about end-of-life care issues (OR, 0.79 [CI, 0.71 to 0 .87]) were less likely to support euthanasia or physician-assisted suicide. During their career, 3.7% of surveyed oncologists had performed euthanasia and 10.8% had performed physician-assisted suicide. Oncologists who were r eluctant to increase the morphine dose for patients in excruciating pain (O R, 0.58 [CI, 0.43 to 0.79]) and those who believed that they had received a dequate training in end-of-life care (OR, 0.86 [CI, 0.79 to 0.95]) were les s likely to have performed euthanasia or physician-assisted suicide. Oncolo gists who reported not being able to obtain all the care that a dying patie nt needed were more likely to have performed euthanasia (P = 0.001). Conclusions: Requests for euthanasia and physician-assisted suicide are lik ely to decrease as training in end-of-life care improves and the ability of physicians to provide this care to their patients is enhanced.