title: Desire for euthanasia or physician-assisted suicide in palliative cancer care.
abstract: OBJECTIVE
  To investigate the attitudes of terminally ill individuals toward the legalization of euthanasia or physician-assisted suicide (PAS) and to identify those who would personally desire such a death.
  
  
  METHODS
  In the Canadian National Palliative Care Survey, semistructured interviews were administered to 379 patients who were receiving palliative care for cancer. Patients who expressed a desire for physician-hastened death were followed prospectively.
  
  
  METHODS
  Attitudes toward the legalization of euthanasia or PAS were determined, as was the personal interest in receiving a hastened death. Demographic and clinical characteristics were also recorded, including a 22-item structured interview of symptoms and concerns.
  
  
  RESULTS
  There were 238 participants (62.8%) who believed that euthanasia and/or PAS should be legalized, and 151 (39.8%) who would consider making a future request for a physician-hastened death. However, only 22 (5.8%) reported that, if legally permissible, they would initiate such a request right away, in their current situations. This desire for hastened death was associated with lower religiosity (p=.010), reduced functional status (p=.024), a diagnosis of major depression (p<.001), and greater distress on 12 of 22 individual symptoms and concerns (p<.025). In follow-up interviews with 17 participants, 2 (11.8%) showed instability in their expressed desire.
  
  
  CONCLUSIONS
  Among patients receiving palliative care for cancer, the desire to receive euthanasia or PAS is associated with religious beliefs; functional status; and physical, social, and psychological symptoms and concerns. Although this desire is sometimes transitory, once firmly established, it can be enduring.
authors.affiliation: Institute for Rehabilitation Research and Development, The Rehabilitation Centre, The Ottawa Hospital, Ottawa, ON, and Department of Psychiatry, University of Manitoba, Winnipeg, Canada. kewilson@ottawahospital.on.ca
authors.forename: Keith G
authors.initials: KG
authors.lastname: Wilson
authors.forename: Harvey Max
authors.initials: HM
authors.lastname: Chochinov
authors.forename: Christine J
authors.initials: CJ
authors.lastname: McPherson
authors.forename: Merika Graham
authors.initials: MG
authors.lastname: Skirko
authors.forename: Pierre
authors.initials: P
authors.lastname: Allard
authors.forename: Srini
authors.initials: S
authors.lastname: Chary
authors.forename: Pierre R
authors.initials: PR
authors.lastname: Gagnon
authors.forename: Karen
authors.initials: K
authors.lastname: Macmillan
authors.forename: Marina
authors.initials: M
authors.lastname: De Luca
authors.forename: Fiona
authors.initials: F
authors.lastname: O'Shea
authors.forename: David
authors.initials: D
authors.lastname: Kuhl
authors.forename: Robin L
authors.initials: RL
authors.lastname: Fainsinger
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Karam
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Clinch
mesh_terms: D000368:Aged; D001293:Attitude to Death; D002170:Canada; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D010166:Palliative Care; D017060:Patient Satisfaction; D011446:Prospective Studies; D017236:Suicide, Assisted