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Linda Ganzini - One of the best experts on this subject based on the ideXlab platform.
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attitudes and experiences of oregon hospice nurses and social workers regarding Assisted Suicide
Palliative Medicine, 2004Co-Authors: Lois L Miller, Linda Ganzini, Theresa A Harvath, Elizabeth R Goy, Molly A Delorit, Ann JacksonAbstract:Background: When the Oregon Death with Dignity Act (ODDA) legalizing physician Assisted Suicide was enacted into law in 1997, Oregon hospice clinicians were uncertain how involved they would be wit...
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oregon physicians responses to requests for Assisted Suicide a qualitative study
Journal of Palliative Medicine, 2004Co-Authors: Steven K Dobscha, Ronald T Heintz, Nancy Press, Linda GanziniAbstract:In 1997, the Oregon Death with Dignity Act was enacted, allowing physicians to prescribe lethal dosages of medication to competent, terminally ill patients who request them. To improve our understanding of physicians' reactions to requests for Assisted Suicide, we performed semistructured interviews of 35 Oregon physicians who had received requests from patients. Interviews were completed in 2000, and audiotaped, transcribed, and analyzed using qualitative techniques. Requests for Assisted Suicide had a powerful impact on physicians and their practices. Physicians often felt unprepared, and experienced apprehension and discomfort before and after receiving requests. Prominent sources of discomfort included concerns about adequately managing symptoms and suffering, not wanting to abandon patients, and incomplete understanding of patients' preferences, especially when physicians did not know patients well. Participation in Assisted Suicide required a large investment of time and was emotionally intense. Reg...
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predictors and correlates of interest in Assisted Suicide in the final month of life among als patients in oregon and washington
Journal of Pain and Symptom Management, 2002Co-Authors: Linda Ganzini, Maria J Silveira, Wendy JohnstonAbstract:To understand the factors associated with interest in Assisted Suicide among terminally ill patients, we surveyed 50 caregivers of decedent amyotrophic lateral sclerosis (ALS) patients from Oregon and Washington regarding perceptions of patients' interest in Assisted Suicide and their physical and emotional state in the last month of life. For 38 caregivers, we had baseline information from the patients themselves, gathered a median of 11 months before death, regarding depression, hopelessness, sense of burden, social support, quality of life, pain, and suffering. According to our respondents, one-third of ALS patients discussed wanting Assisted Suicide in the last month of life. Hopelessness and interest in Assisted Suicide at baseline predicted desire for Assisted Suicide later on. ALS patients who were interested in Assisted Suicide, compared to those who were not, had greater distress at being a burden to others and more insomnia, pain, and discomfort other than pain.
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attitudes of patients with amyotrophic lateral sclerosis and their care givers toward Assisted Suicide
The New England Journal of Medicine, 1998Co-Authors: Linda Ganzini, Susan W Tolle, Wendy Johnston, Bentson H Mcfarland, Melinda A LeeAbstract: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 wit...
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psychiatry and Assisted Suicide in the united states
The New England Journal of Medicine, 1997Co-Authors: Linda Ganzini, Melinda A LeeAbstract:After years of debate over the ethical and legal issues in physician-Assisted Suicide, empirical research is beginning to infuse a realistic clinical perspective into this previously theoretical controversy. Studies reveal that a host of practical issues must be examined as we consider whether to legalize physician-Assisted Suicide in the United States. The appropriate role of psychiatrists in legalized physician-Assisted Suicide has yet to be defined. Groenewoud and colleagues, in a survey of Dutch psychiatrists described in this issue of the Journal, raise complex questions.1 When should a psychiatrist be asked to evaluate a patient who requests assistance in Suicide? What . . .
Melinda A Lee - One of the best experts on this subject based on the ideXlab platform.
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attitudes of patients with amyotrophic lateral sclerosis and their care givers toward Assisted Suicide
The New England Journal of Medicine, 1998Co-Authors: Linda Ganzini, Susan W Tolle, Wendy Johnston, Bentson H Mcfarland, Melinda A LeeAbstract: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 wit...
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psychiatry and Assisted Suicide in the united states
The New England Journal of Medicine, 1997Co-Authors: Linda Ganzini, Melinda A LeeAbstract:After years of debate over the ethical and legal issues in physician-Assisted Suicide, empirical research is beginning to infuse a realistic clinical perspective into this previously theoretical controversy. Studies reveal that a host of practical issues must be examined as we consider whether to legalize physician-Assisted Suicide in the United States. The appropriate role of psychiatrists in legalized physician-Assisted Suicide has yet to be defined. Groenewoud and colleagues, in a survey of Dutch psychiatrists described in this issue of the Journal, raise complex questions.1 When should a psychiatrist be asked to evaluate a patient who requests assistance in Suicide? What . . .
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attitudes of oregon psychiatrists toward physician Assisted Suicide
American Journal of Psychiatry, 1996Co-Authors: Linda Ganzini, Darien S Fenn, Melinda A Lee, Ronald T Heintz, Joseph D BloomAbstract:Objective: After passage, in November 1994, of Oregon ‘s ballot measure legalizing physiciami-Assisted Suicide for termimially ill persons, the authors surveyed psychiatrists in Oregon to determine their attitudes toward Assisted Suicide, the factors influemicimig these attitudes, amid how they might both respomid to amid follow up a request by a primnary care physiciami to evaluate a termnimzally ill patient desirimig Assisted Suicide. Method: Ami amionymous questionmiaire was sent to all 4 1 8 Oregon psychiatrists. Results: Sevemity-sevemi percent ofpsychiatrists (N=32 1) returmied the questiominaire. Two-thirds endorsed the vieiv that a physiciami should he perniitted, umider sonic circumstamices, to write a prescription for a medicatiomi whose sole purpose would he to allow a patient to end his or her life. One-third endorsed the view that this practice should never be permitted. Over half favored Oregomi ‘s Assisted Suicide initiative becoming law. Psychiatrists ‘ positiomi omi legalization of Assisted Suicide imzfluenced the likelihood that they would agree to evaluate patieuits requestimig Assisted Suicide amid how they would f ollow lip ami evaluatiomi ofa competemit patient desirimig Assisted Suicide. Omily 6% of psychiatrists were very confidemit that imia single evaluation they could adequately assess whether a �5ychiatric disorder was impairimig the judgment ofa patiemit requesting Assisted Suicide. �#{231} clusiomis: Psychiatrists in Oregomi are divided in their beliefabout the ethical permissibility of Assisted Suicide, amid their nioral beliefs iuzfluence how the)’ might evaluate a patient requestimig Assisted Suicide, should this practice be legalized. Psychiatrists ‘ confidence iii their ability to determine whether a psychiatric disorder such as depressiomi was impairing the judgmemzt of a patiemit requestimig Assisted Suicide was low. (AmJ Psychiatry 1996; 153:1469-1475)
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legalizing Assisted Suicide views of physicians in oregon
The New England Journal of Medicine, 1996Co-Authors: Melinda A Lee, Linda Ganzini, Heidi D Nelson, Virginia P Tilden, Terri A Schmidt, Susan W TolleAbstract:Background Since the Oregon Death with Dignity Act was passed in November 1994, physicians in Oregon have faced the prospect of legalized physician-Assisted Suicide. We studied the attitudes and current practices of Oregon physicians in relation to Assisted Suicide. Methods From March to June 1995, we conducted a cross-sectional mailed survey of all physicians who might be eligible to prescribe a lethal dose of medication if the Oregon law is upheld. Physicians were asked to complete and return a confidential 56-item questionnaire. Results Of the 3944 eligible physicians who received the questionnaire, 2761 (70 percent) responded. Sixty percent of the respondents thought physician-Assisted Suicide should be legal in some cases, and nearly half (46 percent) might be willing to prescribe a lethal dose of medication if it were legal to do so; 31 percent of the respondents would be unwilling to do so on moral grounds. Twenty-one percent of the respondents have previously received requests for Assisted Suicide...
Gerrit Van Der Wal - One of the best experts on this subject based on the ideXlab platform.
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euthanasia and physician Assisted Suicide among patients with amyotrophic lateral sclerosis in the netherlands
The New England Journal of Medicine, 2002Co-Authors: Jan H Veldink, Gerrit Van Der Wal, John H J Wokke, J Vianney M B De Jong, Leonard H Van Den BergAbstract:Background Amyotrophic lateral sclerosis (ALS) is a disease that causes progressive paralysis leading to respiratory failure. Patients with ALS may consider physician-Assisted Suicide. However, it is not known how many patients, if given the option, would actually decide to end their lives by physician-Assisted Suicide or euthanasia nor at what stage of the disease they would choose to do so. Methods We identified physicians of 279 patients in the Netherlands with a diagnosis of ALS who died between 1994 and 1999. Physicians were asked to fill out a validated questionnaire about the end-of-life decisions that were made. Of 241 eligible physicians, 203 returned the questionnaire (84 percent). Results Of the 203 patients, 35 (17 percent) chose euthanasia and died that way. An additional six patients (3 percent) died as a result of physician-Assisted Suicide. Patients to whom religion was important were less likely to have died as a result of euthanasia or physician-Assisted Suicide. The choice of euthanasia...
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refused and granted requests for euthanasia and Assisted Suicide in the netherlands interview study with structured questionnaire
BMJ, 2000Co-Authors: I Haverkate, Bregje D Onwuteakaphilipsen, Gerrit Van Der Wal, A Van Der Heide, Piet J Kostense, P J Van Der MaasAbstract:In 1995, physicians in the Netherlands received 9700 explicit requests for euthanasia or physician Assisted Suicide, of which 37% were granted and carried out.1 Among the remaining requests, about half were refused by the physician; in the rest of the cases either the patient died before a decision had been reached or the physician's promise of help could be effected, or the patient withdrew the request.2 Knowledge of specific characteristics of refused and granted requests for euthanasia or physician Assisted Suicide may give insight into physicians' decision making and into the role of criteria for prudent practice. We therefore compared the characteristics of refused and granted requests. In 1995 and 1996, 405 Dutch physicians, randomly sampled nationwide and stratified by specialty and region, were interviewed by over 30 specifically trained and experienced physicians using a structured questionnaire. The response rate was …
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clinical problems with the performance of euthanasia and physician Assisted Suicide in the netherlands
The New England Journal of Medicine, 2000Co-Authors: J H Groenewoud, Bregje D Onwuteakaphilipsen, A Van Der Heide, D L Willems, P J Van Der Maas, Gerrit Van Der WalAbstract:Background and Methods The characteristics and frequency of clinical problems with the performance of euthanasia and physician-Assisted Suicide are uncertain. We analyzed data from two studies of euthanasia and physician-Assisted Suicide in the Netherlands (one conducted in 1990 and 1991 and the other in 1995 and 1996), with a total of 649 cases. We categorized clinical problems as technical problems, such as difficulty inserting an intravenous line; complications, such as myoclonus or vomiting; or problems with completion, such as a longer-than-expected interval between the administration of medications and death. Results In 114 cases, the physician's intention was to provide assistance with Suicide, and in 535, the intention was to perform euthanasia. Problems of any type were more frequent in cases of Assisted Suicide than in cases of euthanasia. Complications occurred in 7 percent of cases of Assisted Suicide, and problems with completion (a longer-than-expected time to death, failure to induce coma, ...
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active voluntary euthanasia or physician Assisted Suicide
Journal of the American Geriatrics Society, 1997Co-Authors: Bregje D Onwuteakaphilipsen, M. T. Muller, Gerrit Van Der Wal, Jacques Th. M. Van Eijk, Miel W. RibbeAbstract:OBJECTIVE: To find out why Dutch general practitioners (GPs) and nursing home physicians (NHPs), and patients (according to their physician) opt for active voluntary euthanasia rather than for physician-Assisted Suicide, or vice-versa. DEFINITIONS: The following definitions were used in the study: Euthanasia is the intentional termination of life, by someone other than the patient, at the patient's request; physician-Assisted Suicide is intentionally helping a patient to terminate his or her life at his or her request. DESIGN: Two descriptive, retrospective studies. SETTING: The Netherlands. METHOD: Data were collected by means of anonymous questionnaires sent to a random sample of 521 GPs from the province of North Holland, 521 GPs from the rest of the Netherlands, and all 713 NHPs who were members of the Dutch Association of Nursing Home Physicians. Data were collected over the period 1986–1989 (inclusive) for GPs and the period 1986-June 1990 (inclusive) for NHPs. RESULTS: Forty-eight percent of the Gps, 78% of the NHPs, and about half of the patients who opted for euthanasia did so because of the physical condition of the patient. The reason GPs, NHPs, and patients gave most often for opting for physician-Assisted Suicide was that they wanted ‘as far as possible to let the patient bear the responsibility.’ CONCLUSION: In 38% of all cases for GPs and 57% of all cases for NHPs, only active voluntary euthanasia could be performed because of the patient's condition. In the other cases, where there was a choice, most GPs performed euthanasia, while most NHPs Assisted in Suicide. Active voluntary euthanasia was chosen primarily for medico-technical reasons, whereas physician-Assisted Suicide was selected primarily for moral reasons.
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voluntary active euthanasia and physician Assisted Suicide in dutch nursing homes requests and administration
Journal of the American Geriatrics Society, 1994Co-Authors: Gerrit Van Der Wal, M. T. Muller, Miel W. Ribbe, L M Christ, Jacques Th. M. Van EijkAbstract:Objective: To learn how many requests for voluntary active euthanasia and/or physician-Assisted Suicide (EAS) are made to Dutch nursing home physicians (NHPs) and how often these requests are honored. Design: Retrospective survey. Setting: The Netherlands. Participants: All Dutch NHPs affiliated with the Dutch Association of Nursing Home Physicians (n = 713). Measurements: An anonymous postal questionnaire was sent to all Dutch NHPs affiliated with the Dutch Association of Nursing Home Physicians (n = 713). Respondents were asked how often they had received an explicit request for EAS and whether they had complied with that request. Those who had complied were asked questions about the last occasion on which they had administered either voluntary active euthanasia or physician-Assisted Suicide. Results: The response rate was 86% (n = 582). Of the respondents, 88% had never administered EAS in nursing homes. The remaining 12% (n = 69) had received 164 requests for voluntary active euthanasia and 53 requests for physician-Assisted Suicide in the period 1986 through mid-1990. Of these requests, 74 were granted (51 voluntary active euthanasia and 23 physician-Assisted Suicide). Dutch NHPs together receive an average of 300 requests for EAS a year. They comply with 25 of such requests annually. Conclusion: Not many requests for EAS are made in Dutch nursing homes. Of these requests, fewer than 1 in 10 result in the actual administration of EAS. The data presented are relatively constant for the 4.5-year period studied.
Sheila Payne - One of the best experts on this subject based on the ideXlab platform.
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responses to Assisted Suicide requests an interview study with swiss palliative care physicians
BMJ, 2019Co-Authors: Claudia Gamondi, Gian Domenico Borasio, Pam Oliver, Nancy Preston, Sheila PayneAbstract:Objectives Assisted Suicide in Switzerland is mainly performed by right-to-die societies. Medical involvement is limited to the prescription of the drug and certification of eligibility. Palliative care has traditionally been perceived as generally opposed to Assisted Suicide, but little is known about palliative care physicians’ involvement in Assisted Suicide practices. This paper aims to describe their perspectives and involvement in Assisted Suicide practices. Methods A qualitative interview study was conducted with 23 palliative care physicians across Switzerland. Thematic analysis was used to interpret data. Results Swiss palliative care physicians regularly receive Assisted Suicide requests while none reported having received specific training in managing these requests. Participants reported being involved in Assisted Suicide decision making most were not willing to prescribe the lethal drug. After advising patients of the limits on their involvement in Assisted Suicide, the majority explored the origins of the patient’s request and offered alternatives. Many participants struggled to reconcile their understanding of palliative care principles with patients’ wishes to exercise their autonomy. The majority of participants had no direct contact with right-to-die societies, many desired better collaboration. A desire was voiced for a more structured debate on Assisted Suicide availability in hospitals and clearer legal and institutional frameworks. Conclusions The Swiss model of Assisted Suicide gives palliative care physicians opportunities to develop roles which are compatible with each practitioner’s values, but may not correspond to patients’ expectations. Specific education for all palliative care professionals and more structured ways to manage communication about Assisted Suicide are warranted.
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family caregivers reflections on experiences of Assisted Suicide in switzerland a qualitative interview study
Journal of Pain and Symptom Management, 2018Co-Authors: Claudia Gamondi, Nancy Preston, Murielle Pott, Sheila PayneAbstract:Abstract Context Thousands of family members worldwide are annually involved in Assisted dying. Family participation in Assisted dying has rarely been investigated and families' needs typically are not considered in Assisted dying legislation and clinical guidelines. Objectives To explore family caregivers' reflections on experiences of Assisted Suicide in Switzerland. Methods A cross-sectional qualitative interview study conducted in the Italian- and French-speaking regions of Switzerland. Interpretation and analysis were performed using qualitative content analysis. Results Twenty-eight close relatives and family carers of 18 patients who died by Assisted Suicide in Switzerland were interviewed. Family members perceived their involvement in Assisted Suicide as characterized by five phases; 1) contemplation, 2) gaining acceptance, 3) gaining permission, 4) organization, and 5) aftermath. Families can participate in these phases at diverse levels and with varying degrees of involvement. Important triggers for families and patients for transition between phases include patients' experiences of their life-threatening illnesses and related treatments, their increasing awareness of approaching death, and family member recognition of their loved one's unbearable suffering. Participating in Assisted Suicide created further demanding tasks for families in addition to their role of caregivers. Conclusion Families appeared to be involved in the preparation of Assisted Suicide along with patients, irrespective of their personal values regarding Assisted dying. Support for family members is essential if they are involved in tasks preparatory to Assisted Suicide. Clinical guidelines and policies concerning Assisted dying should acknowledge and address family needs.
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exploring the experiences of bereaved families involved in Assisted Suicide in southern switzerland a qualitative study
BMJ, 2015Co-Authors: Claudia Gamondi, Murielle Pott, Karen Forbes, Sheila PayneAbstract:Background In Switzerland, helping with Assisted Suicide under certain conditions is not prosecuted. With approximately 300 cases annually, this leaves behind a large group of bereaved people where its consequences are mostly unknown. The study aimed to explore family involvement in decision making prior to Assisted Suicide, and to examine their ways of coping during the bereavement period. Methods A qualitative interview study used the principles of Grounded Theory analysis. Eleven relatives of eight patients, who died in Southern Switzerland after Assisted Suicide, participated in semistructured interviews. Results The large majority of family members faced moral dilemmas during the decision-making phase. Their respect for patient9s autonomy was a key justification to resolve dilemmas. Two types of involvement were identified: categorised as ‘passive’ when the decision making was located with the patient, and ‘active’ when Assisted Suicide was proposed by the family member and/or the relative was involved in some way. The relatives reported feelings of isolation during and after Assisted Suicide. Family members reported fear of social stigma and did not openly disclose Assisted Suicide as the cause of death. None of those interviewed received formal psychological support. Conclusions Bereaved families express moral dilemmas, feelings of isolation and secrecy in the management of Assisted Suicide in Southern Switzerland. These features seem underestimated and not sufficiently recognised by the healthcare professionals. Management of Assisted Suicide requests should include consideration of family members’ needs, in addition to those of the patient.
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families experiences with patients who died after Assisted Suicide a retrospective interview study in southern switzerland
Annals of Oncology, 2013Co-Authors: C Gamondi, Murielle Pott, Sheila PayneAbstract:In Switzerland, if certain conditions are met, Assisted Suicide is not prosecuted. International debatesuggests that requests for hasten death are often altered by the provision of palliative care. Aims of the study were toexplore patients’ reasons for choice of Assisted Suicide and family perceptions of the interactions with health careprofessionals.
Jacques Th. M. Van Eijk - One of the best experts on this subject based on the ideXlab platform.
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active voluntary euthanasia or physician Assisted Suicide
Journal of the American Geriatrics Society, 1997Co-Authors: Bregje D Onwuteakaphilipsen, M. T. Muller, Gerrit Van Der Wal, Jacques Th. M. Van Eijk, Miel W. RibbeAbstract:OBJECTIVE: To find out why Dutch general practitioners (GPs) and nursing home physicians (NHPs), and patients (according to their physician) opt for active voluntary euthanasia rather than for physician-Assisted Suicide, or vice-versa. DEFINITIONS: The following definitions were used in the study: Euthanasia is the intentional termination of life, by someone other than the patient, at the patient's request; physician-Assisted Suicide is intentionally helping a patient to terminate his or her life at his or her request. DESIGN: Two descriptive, retrospective studies. SETTING: The Netherlands. METHOD: Data were collected by means of anonymous questionnaires sent to a random sample of 521 GPs from the province of North Holland, 521 GPs from the rest of the Netherlands, and all 713 NHPs who were members of the Dutch Association of Nursing Home Physicians. Data were collected over the period 1986–1989 (inclusive) for GPs and the period 1986-June 1990 (inclusive) for NHPs. RESULTS: Forty-eight percent of the Gps, 78% of the NHPs, and about half of the patients who opted for euthanasia did so because of the physical condition of the patient. The reason GPs, NHPs, and patients gave most often for opting for physician-Assisted Suicide was that they wanted ‘as far as possible to let the patient bear the responsibility.’ CONCLUSION: In 38% of all cases for GPs and 57% of all cases for NHPs, only active voluntary euthanasia could be performed because of the patient's condition. In the other cases, where there was a choice, most GPs performed euthanasia, while most NHPs Assisted in Suicide. Active voluntary euthanasia was chosen primarily for medico-technical reasons, whereas physician-Assisted Suicide was selected primarily for moral reasons.
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voluntary active euthanasia and physician Assisted Suicide in dutch nursing homes requests and administration
Journal of the American Geriatrics Society, 1994Co-Authors: Gerrit Van Der Wal, M. T. Muller, Miel W. Ribbe, L M Christ, Jacques Th. M. Van EijkAbstract:Objective: To learn how many requests for voluntary active euthanasia and/or physician-Assisted Suicide (EAS) are made to Dutch nursing home physicians (NHPs) and how often these requests are honored. Design: Retrospective survey. Setting: The Netherlands. Participants: All Dutch NHPs affiliated with the Dutch Association of Nursing Home Physicians (n = 713). Measurements: An anonymous postal questionnaire was sent to all Dutch NHPs affiliated with the Dutch Association of Nursing Home Physicians (n = 713). Respondents were asked how often they had received an explicit request for EAS and whether they had complied with that request. Those who had complied were asked questions about the last occasion on which they had administered either voluntary active euthanasia or physician-Assisted Suicide. Results: The response rate was 86% (n = 582). Of the respondents, 88% had never administered EAS in nursing homes. The remaining 12% (n = 69) had received 164 requests for voluntary active euthanasia and 53 requests for physician-Assisted Suicide in the period 1986 through mid-1990. Of these requests, 74 were granted (51 voluntary active euthanasia and 23 physician-Assisted Suicide). Dutch NHPs together receive an average of 300 requests for EAS a year. They comply with 25 of such requests annually. Conclusion: Not many requests for EAS are made in Dutch nursing homes. Of these requests, fewer than 1 in 10 result in the actual administration of EAS. The data presented are relatively constant for the 4.5-year period studied.
