"Loss of Self" Most Important in Considering Physician- Assisted Suicide and Euthanasia.(Brief Article)

Patients who would choose physician-assisted suicide or euthanasia do not do so because of unbearable pain or because of physical disintegration, according to a new study carried out by the University of Toronto Joint Centre for Bioethics.

Instead, "The desire for euthanasia or assisted suicide resulted from fear and experience of two main factors: disintegration and loss of community," conclude the authors of a study published in the prestigious British journal The Lancet. "These factors resulted in perceived loss of self," they wrote. "Euthanasia and assisted suicide were seen by participants as means of limiting loss of self."

The study, authored by Dr. James Lavery and others, was intended to answer the question, "What gives rise to desire for euthanasia or assisted suicide?" What separates Dr. Lavery et al.'s research, which included in-depth face-to-face interviews, from previous work on the subject is that the interviewers used open-ended questions that allowed the patients to discuss their feelings freely.

Anthony Back and Robert Pearlman, in a commentary published to accompany the article, observe, "Surprisingly little in the medical literature on such suicide is based on data gathered from patients. Only a few researchers have asked patients directly about their desires for physician-assisted suicide."

Referring to the study, Back and Pearlman note, "For clinicians, this work is a kind of road map into the world of a person with a life-threatening illness who is considering physician-assisted suicide."

The Lavery et al. study interviewed 32 people (31 men and one woman) who had been diagnosed with HIV-1 or AIDS. They were questioned about euthanasia, assisted suicide, and end-of-life medical care issues.

At the start of the interviews, which ranged in length from 40 to 120 minutes, 20 of the patients "reported they had already decided to pursue euthanasia or assisted suicide," while three were against and nine were undecided. It is very significant that "Euthanasia and assisted suicide were not desired as ends in themselves," the authors write. "None of the participants, including the most adamant supporters, desired euthanasia or assisted suicide outside of the circumstances that led to their perception of loss of self."