Attachment styles of Oregonians who request physician-assisted death.
OBJECTIVE
Qualitative analyses suggest that requests for physician-assisted death (PAD) may often be the culmination of a person's lifelong pattern of concern with issues such as control, autonomy, self-sufficiency, distrust of others, and avoidance of intimacy. Such characteristics may be measured by attachment style. We compared family members' reports of attachment style in Oregonians who did and did not request PAD.


METHODS
Eighty-four family members of terminally ill patients who requested PAD before death and 63 members of a comparison group that included family members of terminally ill Oregonians who died without requesting PAD rated their loved ones' attachment style in a one-time survey.


RESULTS
Individuals who requested PAD were most often described as having dismissive personality styles (56%) compared to 41% of comparison individuals, and on continuous measures of relational style, the highest mean score among PAD requesters was for dismissive style. There were marginally significant differences in the proportions of each attachment style when comparing the two groups (p = 0.08).


CONCLUSIONS
Patients' attachment styles may be an important factor in requests for PAD. Recognition of a patient's attachment style may improve the ability of the physician to maintain a constructive relationship with the patient throughout the dying process.
Health Services Research and Development, Department of Veterans Affairs, Portland, Oregon.
Robert L
RL
Oldham
Health Services Research and Development, Department of Veterans Affairs, Portland, Oregon.
Steven K
SK
Dobscha
Health Services Research and Development, Department of Veterans Affairs, Portland, Oregon.
Elizabeth R
ER
Goy
Health Services Research and Development, Department of Veterans Affairs, Portland, Oregon.
Linda
L
Ganzini
D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D009922:Oregon; D026684:Personal Autonomy; D010551:Personality; D036301:Qualitative Research; D017236:Suicide, Assisted / Q000331:legislation & jurisprudence / Q000523:psychology*; D019452:Terminally Ill / Q000331:legislation & jurisprudence / Q000523:psychology*