Physicians' experiences with the Oregon Death with Dignity Act.
Physicians' experiences with the Oregon Death with Dignity Act.
复制标题
DOI：
10.1056/nejm200002243420806
复制
发表时间：
2000-02-24
影响因子：
158.5
通讯作者：
Lee, MA
中科院分区：
文献类型：
--
作者：
Ganzini, L;Nelson, HD;Lee, MA
背景：1997年10月，医生协助自杀在俄勒冈州合法化。有数据显示，病人接受了致命药物的处方，并在服用药物后死亡。有很少的信息，但是，医生的经验与协助suicid.Methods：1999年2月至8月，我们邮寄了一份调查问卷，医生谁有资格根据俄勒冈州死亡与尊严法案规定致命的药物。结果：4053名合格的医生，2649（65%）返回调查。自1997年10月以来，答复者中有144人（5%）共收到221份致命药物处方申请。我们收到了165例患者的结局信息（143例患者的完整信息和另外22例患者的部分信息）。患者的平均年龄为68岁; 76%的患者的预期寿命不到6个月。35%的人要求另一位医生开处方。29名患者（18%）接受了处方，17名（10%）死于服用处方药。20%的患者有抑郁症状;这些患者中没有一个接受过致命药物的处方。在68例患者中，包括11例接受处方药的患者和8例因服用处方药而死亡的患者，医生实施了至少一项实质性的姑息干预，例如控制疼痛或其他症状，转诊到临终关怀计划，咨询或抗抑郁药物试验。46%的接受实质性干预的患者改变了对协助自杀的看法，而15%的未接受实质性干预的患者改变了对协助自杀的看法（P
Background: Physician-assisted suicide was legalized in Oregon in October 1997. There are data on patients who have received prescriptions for lethal medications and died after taking the medications. There is little information, however, on physicians' experiences with requests for assistance with suicide.Methods: Between February and August 1999, we mailed a questionnaire to physicians who were eligible to prescribe lethal medications under the Oregon Death with Dignity Act.Results: Of 4053 eligible physicians, 2649 (65 percent) returned the survey. Of the respondents, 144 (5 percent) had received a total of 221 requests for prescriptions for lethal medications since October 1997. We received information on the outcome in 165 patients (complete information for 143 patients and partial for an additional 22). The mean age of the patients was 68 years; 76 percent had an estimated life expectancy of less than six months. Thirty-five percent requested a prescription from another physician. Twenty-nine patients (18 percent) received prescriptions, and 17 (10 percent) died from taking the prescribed medication. Twenty percent of the patients had symptoms of depression; none of these patients received a prescription for a lethal medication. In the case of 68 patients, including 11 who received prescriptions and 8 who died by taking the prescribed medication, the physician implemented at least one substantive palliative intervention, such as control of pain or other symptoms, referral to a hospice program, a consultation, or a trial of antidepressant medication. Forty-six percent of the patients for whom substantive interventions were made changed their minds about assisted suicide, as compared with 15 percent of those for whom no substantive interventions were made (P