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Abstract & Commentary
Synopsis: An update on Oregon’s assisted suicide program since it became legal in 1997.
Source: Hedberg K, et al. N Engl J Med. 2003;348:961-964.
Physician-assisted suicide has been legal for terminally ill patients in Oregon since October 1997. Since then, 129 patients have chosen to participate in the program and died after ingestion of lethal medication. More than 90% died at home, and about half died in the presence of their physician. The number of patients participating in the program has steadily increased from 24 people during the first year of the program to 58 people in 2002. Interestingly, not all patients who received prescriptions for lethal medications used them. Eight patients receiving such prescriptions in 2001 and 2002 are still alive.
Of the 129 who died following ingestion of lethal medication, 79% had terminal cancer, 8% had ALS, 6% had COPD, and 7% had AIDS, scleroderma, or other heart and lung disease. Rates of physician-assisted suicide were significantly higher for patients with ALS and terminal cancer than other terminal diseases. Compared with Oregon residents who died of the same underlying disease, rates of physician-assisted suicide were higher among those who were divorced, or had higher levels of education, and they tended to be younger.
Comment by Carol A. Kemper, MD, FACP
These data suggest that younger, better-educated people may be more accepting of physician-assisted suicide. Although relatively few people chose to participate, the program appears to be slowly gaining in acceptance.
Dr. Kemper is Clinical Associate Professor of Medicine, Stanford University, Division of Infectious Diseases; Santa Clara Valley Medical Center, Santa Clara, Calif.