Robert Pearlman, MD, MPH, Professor of Medicine at the Departments of Medicine, Medical History and Ethics, and Health Services, University of Washington, and Helene Starks, MPH, PhD, Assistant Professor in the Department of Medical History and Ethics at the University of Washington, Seattle, wrote in their chapter "Why Do People Seek Physician-Assisted Death?" that appeared in the 2004 book Physician-Assisted Dying: The Case for Palliative Care and Patient Choice:

“Popular explanations for physician-assisted death include inadequate treatment for pain or other symptoms, depression, hopelessness, and socioeconomic stressors, such as concerns about the burden of increasing dependency on other members of the family and the economic hardship associated with the costs of health care…

In our interviews with thirty-five families, we asked questions about the history of the patient’s illness, the patient’s stated reasons for seeking aid in dying, and other factors influencing the pursuit of physician-assisted death, as well as the manner of death. Our analysis identified nine common factors. No single factor on its own ever accounted for a serious interest in a hastened death. Rather, interest usually arose out of an interactive process involving multiple factors in three broad categories…

Motivating Factor

  • Illness-related experiences
    • Feeling weak, tired, and uncomfortable 24 (69%)
    • Loss of function 23 (66%)
    • Pain or unacceptable side effects of pain medication 14 (40%)
  • Threats to sense of self
    • Loss of sense of self 22 (63%)
    • Desire for control 21 (60%)
    • Long-standing beliefs in favor of hastened death 5 (14%)
  • Fears about the future
    • Fears about future quality of life and dying 21 (60%)
    • Negative past experiences with dying 17 (49%)
    • Fear of being a burden on others 3 (9%).”
2004