Attitudes of patients with amyotrophic lateral sclerosis and their care givers toward assisted suicide
Attitudes of patients with amyotrophic lateral sclerosis and their care givers toward assisted suicide
复制标题
DOI：
10.1056/nejm199810013391406
复制
发表时间：
1998-10-01
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;Johnston, WS;Lee, MA
背景和方法肌萎缩侧索硬化症(ALS)是一种神经肌肉疾病，通常在确诊后三到五年内导致逐渐瘫痪、呼吸衰竭和死亡。在1995至1997年间，我们调查了俄勒冈州和华盛顿州的这种疾病患者，以及他们的家庭照顾者，以确定他们对协助自杀的态度。患者被认为愿意考虑协助自杀，如果他们同意这一说法，“在某些情况下，我会考虑为一种唯一目的是结束我生命的药物开处方”，而不同意这一说法，“我永远不会要求或服用一种唯一目的是结束我生命的药物的处方。”1994年，俄勒冈州选民批准了《俄勒冈州死亡与尊严法案》，将医生协助自杀合法化，但直到1997年10月这项研究的数据收集完成后，该法案才生效。结果在140名符合条件的ALS患者中，100人(71%)和91名家庭照顾者同意参与研究。ALS患者的平均年龄为54岁；自确诊以来的平均病程为2.8年。56名患者(56%)表示，他们会考虑协助自杀，56名患者中有44名同意这一说法，“如果医生协助自杀是合法的，我会要求医生开出致命的处方。”一名患者会立即服用这种药物，36名患者会保留下来供未来使用。与反对协助自杀的患者相比，那些认为其更有可能是男性、受教育程度较高、不太可能信教、绝望得分较高、生活质量较低的患者。91例中有66例(73%)护理者和患者对协助自杀的态度相同。结论在俄勒冈州和华盛顿州，我们调查的大多数ALS患者会考虑协助自杀。许多人会在打算使用之前很久就要求获得致命剂量的药物处方。(《英国医学杂志》1998；339：967-73。)(C)1998年，马萨诸塞州医学会。
Background and Methods Amyotrophic lateral sclerosis (ALS) is a neuromuscular disease that causes gradual paralysis, respiratory failure, and death, usually within three to five years after it has been diagnosed. Between 1995 and 1997, we surveyed patients with this disease in Oregon and Washington, as well as their family care givers, in order to determine their attitudes toward assisted suicide. Patients were considered to be willing to contemplate assisted suicide if they agreed with the statement, "Under some circumstances I would consider taking a prescription for a medicine whose sole purpose was to end my life," and disagreed with the statement, "I would never request or take a prescription for a medication whose sole purpose was to end my life." The Oregon Death with Dignity Act, which legalized physician-assisted suicide, was approved by Oregon voters in 1994 but did not go into effect until October 1997, after data collection for this study had been completed.Results Of 140 eligible persons with ALS, 100 (71 percent) agreed to participate in the study, as did 91 family care givers. The mean age of the patients with ALS was 54 years; the mean duration of illness since the diagnosis was 2.8 years. Fifty-six patients (56 percent) said they would consider assisted suicide, and 44 of the 56 agreed with the statement, "If physician-assisted suicide were legal, I would request a lethal prescription from a physician." One patient would have taken the medication immediately, and 36 would have kept it for future use. As compared with the patients who were opposed to assisted suicide, those who would consider it were mure likely to be men, had a higher level of education, were less likely to be religious, had higher scores for hopelessness, and rated their quality of life as lower. In 66 of 91 instances (73 percent), care givers and patients had the same attitude toward assisted suicide.Conclusions In Oregon and Washington, a majority of persons with ALS whom we surveyed would consider assisted suicide. Many would request a prescription for a lethal dose of medication well before they intended to use it. (N Engl J Med 1998;339: 967-73.) (C)1998, Massachusetts Medical Society.