Euthanasia and Physician Assisted Suicide

iStock_84620773_MEDIUMShould physicians assist people who wish to end their lives? Whatever your view on that matter, a study Rick and I discuss on PodMed this week attempts to quantify just how much euthanasia, where the physician administers drugs to end life, or the patient does so with drugs a physician has prescribed, so-called physician assisted suicide (PAS), takes place currently in places where the practice is legal.  That's published in JAMA.

This rather exhaustive study took a look at the five countries where euthanasia and PAS is legal: Canada, the Netherlands, Belgium, Luxembourg, Colombia, and the five US states where PAS but not euthanasia are legal: Oregon, Montana, California, Vermont, and Washington. Survey data beginning in 1947 was examined through 2015, as was data from death certificates and locations with reporting requirements relative to these practices.  Briefly, the study found that while the practice is being legalized more and more, rates of actual utilization remain about the same.  There is no evidence that vulnerable populations are being targeted, and the group that seems to utilize the practice most often are people with cancer.

Of surprise to both Rick and me, pain was not the primary reason cited by people who chose to end their lives, but rather a wish to die with dignity, having experienced a loss of autonomy and ability to enjoy life. The majority of people who make this election are educated, white, and older. In short, we feel the study does not support the idea that somehow legalizing the practice would expand its use, perhaps to those who haven't chosen to die themselves.

Other topics this week include two studies we treated as one on breast cancer trials in NEJM, staph infections in families in Annals of Internal Medicine, and an IOM report on biomarkers.  Until next week, y'all live well.

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