Research Highlights
Experience of Hospice Nurses and Social Workers
Taken from the Veterans Health Administration Highlights dated August 22, 2002
In the August 22 New England Journal of Medicine, Oregon researchers report on the first study to document experiences of hospice nurses and social workers with patients who request assisted suicide under the Oregon Death with Dignity Act.
Although assisted suicide is rare in Oregon, 45 percent of 306 nurses and 91 social workers surveyed for the study had cared for a patient who requested a lethal prescription, and 30 percent had cared for a client who received one.
The hospice caregivers ranked a patient’s desire to stay in control as very important in the decision to request assisted suicide. Contrary to concerns expressed by some in the medical community, the caregivers ranked depression, lack of social support and fear of being a financial drain on family members as least important factors in the decision, said study leader Linda Ganzini, M.D., director of the Palliative Care Fellowship at the Portland VA Medical Center and professor of psychiatry at Oregon Health & Science University.
The study’s findings may point the way to new approaches in end-of-life care as researchers gain a better understanding of factors that might allow terminally ill patients to feel that they retain control of the dying process without turning to assisted suicide.
Among other survey findings, 98 percent of the hospice nurses had discussed the request with a coworker, 77 percent of the requests had been presented at a hospice interdisciplinary conference on patient care, and 61 percent of hospice patients requesting assisted suicide had been seen by a social worker.
The VA and OHSU researchers plan further studies to better understand what control means to dying patients and to develop interventions that might strengthen that sense of control. Although physician-assisted suicide is authorized under Oregon state law, it is not authorized anywhere within the VA health care system.