Physician resource use and willingness to participate in assisted suicide.


Journal Article

OBJECTIVE:To explore the relationship between general internists' tendency to conserve medical resources and their willingness to participate in physician-assisted suicide (PAS). DESIGN AND PARTICIPANTS:Survey of a random sample of general internists in 6 urban areas of the United States. MEASUREMENTS:We assessed the physicians' use of medical resources by constructing a scale based on 6 hypothetical clinical scenarios in which respondents were given a choice between resource-intensive and resource-conserving options. We then presented a scenario of a competent terminally ill patient with breast cancer making stable and persistent requests for PAS. RESULTS:Sixty-seven (33%) of the 206 respondents indicated that they would participate in the suicide of the depicted patient. In a multivariate model, physicians who were more conservative with resources were 6.4 times more likely than their resource-intensive counterparts to prescribe the requested drugs (P = .02); minority physicians were less willing than whites to participate in PAS (odds ratio, 0.34; P = .03). Physicians' number of years in practice, location, sex, reported percentage of fee-for-service patients, and self-reported strength and direction of financial incentives in the respondents' practices were not associated with willingness to prescribe drugs for PAS. CONCLUSIONS:Most general internists, especially minority physicians, are personally reluctant to participate in PAS. While the characteristics of their practices do not affect PAS, physicians who tend to practice resource-conserving medicine are significantly more likely than their resource-intensive counterparts to provide a lethal prescription at the request of a terminally ill patient.

Full Text

Cited Authors

  • Sulmasy, DP; Linas, BP; Gold, KF; Schulman, KA

Published Date

  • May 1998

Published In

Volume / Issue

  • 158 / 9

Start / End Page

  • 974 - 978

PubMed ID

  • 9588430

Pubmed Central ID

  • 9588430

Electronic International Standard Serial Number (EISSN)

  • 1538-3679

International Standard Serial Number (ISSN)

  • 0003-9926

Digital Object Identifier (DOI)

  • 10.1001/archinte.158.9.974


  • eng