Psychological Pain Often Drives Physician-Assisted Suicide

Doctor filling out paperwork with patientPsychological suffering due to lost autonomy, not physical pain, may be a more likely motivator for those who seek physician-assisted suicide, according to a study published in The New England Journal of Medicine.

The study included 74 people who inquired about physician-assisted suicide in the year following Canada’s passage of the Medical Assistance in Dying (MAiD) law. MAiD decriminalized physician-assisted suicide for people with chronic and terminal illnesses in an advanced stage. People who elect to use the MAiD law undergo several evaluations before they receive a lethal injection in a hospital setting.

Emotional Pain a Factor in Physician-Assisted Suicide

The study used data from Canada’s University Health Network. Between March 2016 and March 2017, 74 people sought information about physician-assisted suicide. Seventy-four percent of inquiries were from people with cancer. Twenty-nine underwent assessment for suicide to determine whether they were capable of consenting to the procedure. Of those, 25 were approved. Nineteen people (26%) ultimately decided in favor of medically assisted suicide.

Most people seeking a medically supported suicide cited psychological distress as a reason for their desire to die. Few participants said poorly controlled physical pain was their primary motivation.

Overall, 95% said a loss of autonomy figured prominently in their decision. Patients often said their quality of life was poor, and many viewed physician-assisted suicide as a way to regain control over the circumstances of their death.

Are People Seeking Physician-Assisted Suicide Depressed?

A 2005 study published in the Journal of General Internal Medicine had similar results. In that study, researchers interviewed the loved ones of 35 people who had chosen to die with the assistance of a doctor. Loss of a sense of self, poor quality of life, and loss of autonomy related to the illness all figured prominently in the decision to die. None of the people in that study showed significant signs of depression when planning their physician-assisted death.

References:

  1. Cha, A. E. (2017, May 26). It’s not pain but ‘existential distress’ that leads people to assisted suicide, study suggests. Retrieved from https://www.washingtonpost.com/news/to-your-health/wp/2017/05/24/its-not-pain-but-existential-distress-that-leads-people-to-assisted-suicide-study-suggests/?utm_term=.b15d38316d51
  2. Li, M., MD, PhD, Watt, S., HBBA, MHA, Escaf, M., HBBA, MHA, Gardam, M., MD, Heesters, A., MA, O’Leary, G., MB, & Rodin, G., MD. (2017). Medical assistance in dying–implementing a hospital-based program in Canada. New England Journal of Medicine, 376(21), 2082-2088. doi:10.1056/nejmms1700606
  3. Pearlman, R. A., MD, MPH, Hsu, C., PhD, Starks, H., MPH, Back, A. L., MD, Gordon, J. R., PhD, . . . Battin, M. P., PhD. (2005). Motivations for physician-assisted suicide. Journal of General Internal Medicine, 20(3), 234-239. doi:10.1111/j.1525-1497.2005.40225.x

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  • coley

    coley

    June 7th, 2017 at 12:00 PM

    This would be a tough position for anyone to get to and I know that doctors and caregivers strive to do anything that is within their power to help a patient who is suffering like this. I think that if someone is of sound mind then they should be able to make the decisions about how the end of their life should go, not the state governments. I think that doctors should be able to then help those patients without fear of losing their professional licenses. I wouldn’t want to live in a way that was so different than the life that I had once led. I know that there are many more people out there who feel the exact same way that I feel.

  • Heidi

    Heidi

    June 9th, 2017 at 10:35 AM

    For some reason there will be that group of people for whom they do not believe that it is enough that someone suffers from psychological pain to go through with this nor to have the actions supported.
    For many they feel like only physical pain of some kind should be what is considered as justification if at all.’They do not realize that there are thousands of people for whom the psychological pain is often much more painful that simply the physical.

  • joe

    joe

    June 12th, 2017 at 2:15 PM

    It just feels wrong for me that someone who is trained to save lives would get into the whole business of ending them

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