Linda Ganzini, MD, MPH, Professor of Psychiatry and Medicine Senior Scholar at the Center for Ethics in Health Care, Oregon Health & Science University, Theresa Harvath, PhD, RN, Associate Professor at the Oregon Health & Science University School of Nursing, Portland, Ann Jackson, MBA, Executive Director and CEO of the Oregon Hospice Association, et al. wrote in their Aug. 22, 2002 article, "Experiences of Oregon Nurses and Social Workers with Hospice Patients Who Requested Assistance with Suicide," that appeared in the New England Journal of Medicine:

“According to the hospice nurses, the most important reasons for requesting assistance with suicide, among patients who received prescriptions for lethal medications, were a desire to control the circumstances of death, a desire to die at home, the belief that continuing to live was pointless, and being ready to die. Depression and other psychiatric disorders, lack of social support, and concern about being a financial drain were, according to nurses, relatively unimportant. Seventy-seven percent of the nurses reported that patients who received prescriptions for lethal medications were more fearful of loss of control over the circumstances of death than were other hospice patients, whereas 8 percent reported that such patients were less fearful than other hospice patients. Sixty-two percent of the nurses said that patients who received prescriptions for lethal medications were more likely to be concerned about loss of independence than were other hospice patients, whereas 9 percent said that such patients were less concerned about loss of independence than were other hospice patients.

Hospice social workers reported that the desire to control the circumstances of death, the wish to die at home, loss of independence or fear of such loss, and loss of dignity or fear of such loss were the most important reasons for requesting prescriptions for lethal medications; the median score for all these reasons was 5 on the 1-to-5 scale. They ranked lack of social support and depression as the least important reasons; the median score for both was 1…

Many of the nurses reported that pain or fear of pain was an important reason for the request for assistance with suicide. Only 15 percent of the nurses, however, reported that the patient had more pain, on average, than other hospice patients, whereas 42 percent reported that the patient had less pain, on average, than other hospice patients. Other physical symptoms, such as fatigue and dyspnea, were reported to be only moderately important reasons for the request, and 58 percent of the nurses reported that the patients who received prescriptions for lethal medications had less dyspnea than other hospice patients.”

Aug. 22, 2002