Euthanasia and physician-assisted suicide: attitudes and experiences of oncology patients, oncologists, and the public

Emanuel, Ezekiel J.; Daniels, Elisabeth R.; Fairclough, Diane L.; Clarridge, Brian

doi:10.1016/s0140-6736(96)91621-9

Cited by 327 publications

(223 citation statements)

References 23 publications

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“…The studies mentioned before [11][12][13][14][15][16] and others 32,33 indicated that approximately 10 -20% of cancer patients had some kind of suicidal ideation although the subjects, time of investigation in the disease process, and assessment methods differed in each study. To the best of our knowledge, only one study investigated the prevalence of suicidal ideation among lung carcinoma patients, and the subjects were patients who were undergoing chemotherapy or radiotherapy.…”

Section: Discussion Prevalence Of Suicidal Ideationmentioning

confidence: 99%

“…They suggested that several factors, such as physical, psychological, and existential distress, including pain, impairment of physical functioning, depression, loss of independence, and loss of autonomy, account for the suicides among cancer patients. 9,10 In addition, several studies have demonstrated that the prevalence of the desire for death among terminally ill cancer patients is not rare (range, 8.5-17.4%) [11][12][13][14] and that pain, weakness, loss of control, depression, hopelessness, and social support factors are associated significantly with the desire for death. [11][12][13][14][15][16][17] However, the samples in these studies were heterogeneous and the study designs were cross-sectional, calling causality into question.…”

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confidence: 99%

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Predictive factors for suicidal ideation in patients with unresectable lung carcinoma

Akechi

Okamura

Nishiwaki

et al. 2002

Cancer

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Agglomerate particulate fluidization (APF), consisting of uniform bubbleless fluidization of agglomerated fine particles, has been observed in some fluidized beds of fine and ultrafine powders. Experiments performed in centrifugal fluidized beds (CFB) and vibrofluidized beds (VFB) show that the quality of fluidization is improved by increased effective acceleration. The Richardson‐Zaki modified equation is used, and a proposed criterion for agglomerate size is presented in order to predict the effect of the increase of gravitational acceleration on the APF bed. Following, model predictions are compared with experimental data on VFB of xerographic toners (particle size ≈ 10μ m) displaying APF in a wide interval of gas velocities. It is seen that the agglomerate size and agglomerate volume fraction ϕ* decrease as the effective acceleration is increased. The agreement with the model predictions is good, but at some critical acceleration visible bubbling is stimulated. At bubbling stimulation ϕ* is close to the value of ϕ* at the onset of bubbling in the absence of external vibrations when the gas velocity is increased up to the minimum bubbling velocity. This result indicates that the agglomerate size cannot be decreased indefinitely since at some critical point the concentration and size of local voids can be higher enough to yield the irreversible coalescence of voids into large bubbles. Particle agglomeration is, therefore, essential at some extent to the uniform fluidized state observed for fine particles. © 2006 American Institute of Chemical Engineers AIChE J, 2006

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Section: Discussion Prevalence Of Suicidal Ideationmentioning

confidence: 99%

mentioning

confidence: 99%

Predictive factors for suicidal ideation in patients with unresectable lung carcinoma

Akechi

Okamura

Nishiwaki

et al. 2002

Cancer

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“…For strata the variable "specialty" was set; weights were attributed according to the sample fraction of each "specialty" per country. As previous studies show that different factors infl uence attitudes towards end-of-life decisions, e. g. culture and physicians' characteristics (Anderson & Caddell 1993;Emanuel et al 1996;Hinkka et al 2002;Rebagliato et al 2000;Vincent 1999;Voltz et al 1998;) multinomial logistic regression analysis was used to investigate, besides the type of questionnaire (main/non responder), the infl uence of these potential determinants towards the attitudes items (answer categories: strongly agree/agree -neutral -strongly disagree/disagree). Independent variables were: questionnaire (main/non-responder), country (Denmark, the Netherlands, Sweden, Switzerland), sex (male/female), age (>50 years/<50 years), number of terminal patients (0 patients/>0 patients) and religious affi liation (roman catholic, protestant, other religion, no religion, no philosophy of life).…”

Section: End-of-life Decisions Includedmentioning

confidence: 93%

Responders and non-responders in a study on medical end-of-life decisions in Denmark, the Netherlands, Sweden and Switzerland

et al. 2006

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On behalf of the EURELD consortium SummaryObjectives: To determine the direction and magnitude of participation bias in end-of-life research. Methods:Within the framework of a European survey on medical end-of-life decisions, a non-response study was conducted among physicians in Denmark, the Netherlands, Sweden and Switzerland. People were asked about their attitudes and experiences in the area of medial end-of-life decision. The response rates ranged from 12.8 % (Netherlands) to 39.4 % (Switzerland). The responders (n = 5 403) and the non-responders (n = 866) were compared regarding socio-demographic characteristics, experiences with terminal patients and agreement with attitudes towards "end-of-life decisions". The reasons for non-participation to the study were analyzed.Results: Non-response did not cause socio-demographic distortion, but non-responders had statistically signifi cantly fewer terminal patients than responders. Agreement rates were statistically signifi cantly higher among responders than among non-responders for euthanasia, non-treatment decision and life-preserving statements. Neutral answers were statistically signifi cantly more frequent among non-responders than among responders for life-preserving and euthanasia statements. The most commonly mentioned reason for non-participation was "lack of time". Conclusion:Non-participation does cause an overestimation of proponents of life-shortening, as well as of life-preserving endof-life decisions. Non-responders more often have ambiguous attitudes towards end-of-life decisions than responders.

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“…More than one-half of oncologists have received requests for assistance in dying, 8 and almost 15% reported having participated in euthanasia or PAS. 9 However, even after legalization of PAS in Oregon, only 7% of physicians reported having written prescriptions for lethal drugs.…”

Section: Do Physicians Hasten Death?mentioning

confidence: 99%

Judging the Quality of Mercy: Drawing a Line Between Palliation and Euthanasia

Morrison¹,

Kang

2014

Pediatrics

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Clinicians frequently worry that medications used to treat pain and suffering at the end of life might also hasten death. Intentionally hastening death, or euthanasia, is neither legal nor ethically appropriate in children. In this article, we explore some of the historical and legal background regarding appropriate end-of-life care and outline what distinguishes it from euthanasia. Good principles include clarity of goals and assessments, titration of medications to effect, and open communication. When used appropriately, medications to treat symptoms should rarely hasten death significantly. Medications and interventions that are not justifiable are also discussed, as are the implications of palliative sedation and withholding fluids or nutrition. It is imperative that clinicians know how to justify and use such medications to adequately treat suffering at the end of life within a relevant clinical and legal framework. Pediatrics 2014;133:S31-S36

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Euthanasia and physician-assisted suicide: attitudes and experiences of oncology patients, oncologists, and the public

Cited by 327 publications

References 23 publications

Predictive factors for suicidal ideation in patients with unresectable lung carcinoma

Predictive factors for suicidal ideation in patients with unresectable lung carcinoma

Responders and non-responders in a study on medical end-of-life decisions in Denmark, the Netherlands, Sweden and Switzerland

Judging the Quality of Mercy: Drawing a Line Between Palliation and Euthanasia

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