Oregon emergency physicians' experiences with, attitudes toward, and concerns about physician-assisted suicide.
OBJECTIVE
To determine emergency physicians' (EPs') attitudes toward physician-assisted suicide (PAS), factors associated with those attitudes, current experiences with attempted suicides in terminally ill persons, and concerns about the impact of legalizing PAS on emergency medicine practice.


METHODS
A cross-sectional, anonymous mailed survey was taken of EPs in the state of Oregon.


RESULTS
Of 356 eligible physicians, 248 (70%) returned the survey. Of the respondents, 69% indicated that PAS should be legal, 65% considered PAS consistent with the physician's role, and 19% believed that it is immoral. The respondents were concerned that patients might feel pressure if they perceived themselves to be either a care burden on others (82%) or a financial stress to others (69%). Only 37% indicated that the Oregon initiative has enough safeguards to protect vulnerable persons. Support for legalization was not associated with gender, age, or practice location. Respondents with no religious affiliation were most supportive of PAS (p < 0.001), and Catholic respondents were least suppportive (p = 0.03). A majority (58%) had treated at least 1 terminally ill patient after an apparent overdose. Most respondents (97%) indicated at least 1 circumstance for which they would sometimes be willing to let a terminally ill patient die without resuscitation after PAS if the Oregon initiative becomes law: if verified with an advance directive from the patient (81%), with documentation in writing from the physician (73%), after speaking to the primary physician (64%), if a competent patient verbally confirmed intent (60%), or if the family verbally confirmed intent (52%).


CONCLUSIONS
Although the majority of Oregon EPs favor the concept of legalization of PAS, most have concerns that safeguards in the Oregon initiative are inadequate to protect vulnerable patients. These physicians would consider not resuscitating terminally ill patients who have attempted suicide under the law's provisions, only in the setting of documentation of the patient's intent.
Oregon Health Sciences University, School of Medicine, Department of Emergency Medicine, Portland 97201-3098, USA. schmidtt@ohsu.edu
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D000328:Adult; D016223:Advance Directives; D000368:Aged; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003657:Decision Making; D004282:Documentation; D004635:Emergency Medicine / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D004992:Ethics, Medical; D005066:Euthanasia, Passive / Q000331:legislation & jurisprudence / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009922:Oregon; D010348:Patient Care Team; D010819:Physician's Role; D010820:Physicians / Q000523:psychology*; D012068:Religion and Medicine; D012297:Right to Die / Q000331:legislation & jurisprudence; D017236:Suicide, Assisted / Q000331:legislation & jurisprudence / Q000523:psychology*; D013406:Suicide, Attempted / Q000331:legislation & jurisprudence / Q000523:psychology* / Q000706:statistics & numerical data