Assisted dying uptake explored
Wednesday July 6th, 2016
Doctors have reported the first systematic survey of the impact of the legalisation of assisted dying in a growing number of countries and states.
Dr
Ezekiel Emanuel of University of Pennsylvania, USA, and colleagues examined
available data on attitudes and practices around euthanasia and physician-assisted
suicide.
They found it increasingly being legalised in the US, Canada, and Europe, - but still used "rarely". The top group of patients involved have cancer. Several countries have legalised the practices, and a number of countries are considering legalisation, the authors wrote in The Journal of the American Medical Association yesterday (5 July).
At present, it is legal in the Netherlands, Belgium, Luxembourg, Colombia, and Canada (nationally, since June 2016). In the US, physician-assisted suicide is legal in Oregon, Washington, Montana, Vermont, and California. It is also legal in Switzerland.
The rate of all deaths reported as euthanasia or physician-assisted suicide in areas where it is legal varies from 0.3% to 4.6% of all deaths, with over 70% being for cancer patients, they report. The main motivations appear to be psychological, say the researchers, fear of losing autonomy and no longer enjoying life's activities and other forms of mental distress, rather than pain as expected.
In terms of public support, this ranges from 47% to 69%. It tends to be higher in Western Europe, but support is falling in Central and Eastern Europe.
The researchers say that in most countries, except for the Netherlands and Belgium, doctors do not support assisted dying as much as the public.
Only studies across in all countries "can help determine whether and how symptom management differs between patients requesting euthanasia or physician-assisted suicide and those who do not request these interventions," the team states.
Dr Emanuel said last night: “We know these aren’t flawless procedures, we know that they have mistakes and complications, we just don’t know the exact rate and the full nature of them.
"Worries about widespread abuse of these practices, that people who don’t have insurance or poor people might be predominantly targeted, do not seem to be borne out by the data.”
He added: “It behoves us to actually look at the practices and try to understand how they work, how well they work, what the problems are before we rush to legalise it in a lot of other countries.”
He said there was no indication of the rate of complications from procedures - but there were potential complications.
Emanuel, E. J. et al. Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the United States, Canada, and Europe. JAMA 5 July 2016 doi:10.1001/jama.2016.8499 [abstract]
Tags: Cancer | Elderly Health | Mental Health | North America | World Health
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