This article is more than 5 years old. Information may no longer be current.

Most common motivations for euthanasia, physician-assisted suicide involve psychological well-being

Primary motivations for requesting euthanasia or physician-assisted suicide were associated with psychological well-being and not physical pain, according to recent findings.

“There are perceptions that euthanasia and physician-assisted suicide are widespread regardless of its legal status, that it’s quick and painless, and flawless. But the best data we have on these issues is about 15 years old,” Ezekiel J. Emanuel, MD, PhD, of Perelman School of Medicine, University of Pennsylvania, Philadelphia, said in a press release. “In the United States there’s been an increase in legalization since Oregon legalized [physician-assisted suicide], and several other states are considering passing legislation that would make these practices legal, but we don’t currently have a comprehensive understanding of the practices themselves, or how the public and health care providers view them. We need more data before turning to these practices as a solution for end-of-life care.”

Ezekiel J. Emanuel

To assess legal status, attitudes and practices of euthanasia and physician-assisted suicide, researchers analyzed polling data and published surveys of the general population and physicians, official state and country databases, physician interviews and death certificate studies from 1947 to 2016.

Analysis indicated that euthanasia or physician-assisted suicide is legally practiced in the Netherlands, Belgium, Luxembourg, Colombia and Canada. Physician-assisted suicide, excluding euthanasia, is legal in Switzerland and five U.S. states: California, Montana, Oregon, Washington, and Vermont.

Public support for euthanasia and physician-assisted suicide has plateaued in the United States since the 1990s, ranging from 47% to 69%.

In Western Europe, public support for euthanasia and physician-assisted suicide is increasingly strong, while support has decreased in Central and Eastern Europe.

In the U.S., less than 20% of clinicians reported receiving requests for euthanasia or physician-assisted suicide and 5% or less have complied.

Less than 1% of licensed physicians wrote prescriptions for physician-assisted suicide per year in Oregon and Washington.

At least half of physicians reported ever receiving a request in the Netherlands and Belgium and 60% of Dutch physicians had ever granted these requests.

More than 70% of euthanasia and physician-assisted suicide cases involved individuals with cancer.

Euthanasia or physician-assisted suicide patients were more likely to be older, white and well-educated.

Pain was not a commonly reported primary motivation, according to researchers.

A significant portion of individuals who received physician-assisted suicide in Oregon, Washington and Belgium reported being enrolled in hospice or palliative care.

“What data we have strongly suggests that the dominant motivations for requesting euthanasia or [physician-assisted suicide] are loss of autonomy and dignity, the inability to enjoy life and regular activities, or other mental illnesses, rather than physical pain,” Emanuel said in the release. “However, given the incomplete and outdated information available about the practices of assisted dying, collecting reliable data to evaluate end-of-life practices should be prioritized around the world, not just in countries legalizing euthanasia or [physician-assisted suicide].” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.