Seven deaths in Darwin: case studies under the Rights of the Terminally Ill Act, Northern Territory, Australia.
BACKGROUND
During the 9 months between July, 1996, and March, 1997, the provision of euthanasia for the terminally ill was legal in the Northern Territory of Australia. Seven patients made formal use of the Rights of the Terminally Ill (ROTI) Act; four died under the Act. We report their clinical details and the decision-making process required by the Act.


METHODS
We taped in-depth interviews with the general practitioner who provided euthanasia. Further information was available from public texts created by patients, the media, and the coroner.


RESULTS
All seven patients had cancer, most at advanced stages. Three were socially isolated. Symptoms of depression were common. Having met criteria of the Act, some patients deferred their decision for a time before proceeding with euthanasia. Medical opinions about the terminal nature of illness differed.


CONCLUSIONS
Provision of opinions about the terminal nature of illness and the mental health of the patient, as required by the ROTI Act, created problematic gatekeeping roles for the doctors involved.
Kissane
D W
DW
University of Melbourne Centre for Palliative Care, Kew, Victoria, Australia. dwk@rubens.its.unimelb.edu.au
Street
A
A
Nitschke
P
P
D000368:Aged; D001293:Attitude to Death; D003657:Decision Making; D033101:Euthanasia, Active, Voluntary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology / Q000523:psychology*; D015876:Northern Territory; D010819:Physician's Role; D036301:Qualitative Research; D012106:Research; D012297:Right to Die / Q000331:legislation & jurisprudence*; D012934:Social Isolation; D013315:Stress, Psychological; D017236:Suicide, Assisted / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D035501:Uncertainty