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Volume 38, Issue 6, Pages 807-815 (December 2009)


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Mental Health Outcomes of Family Members of Oregonians Who Request Physician Aid in Dying

Linda Ganzini, MD, MPHabCorresponding Author Informationemail address, Elizabeth R. Goy, PhDab, Steven K. Dobscha, MDab, Holly Prigerson, PhDcd

Accepted 22 April 2009. published online 25 September 2009.

Abstract 

Oregon legalized physician aid in dying over 10 years ago but little is known about the effects of this choice on family members' mental health. We surveyed 95 family members of decedent Oregonians who had explicitly requested aid in dying, including 59 whose loved one received a lethal prescription and 36 whose loved one died by lethal ingestion. For comparison purposes, family members of Oregonians who died of cancer or amyotrophic lateral sclerosis also were surveyed. A mean of 14 months after death, 11% of family members whose loved one requested aid in dying had major depressive disorder, 2% had prolonged grief, and 38% had received mental health care. Among those whose family member requested aid in dying, whether or not the patient accessed a lethal prescription had no influence on subsequent depression, grief, or mental health services use; however, family members of Oregonians who received a lethal prescription were more likely to believe that their loved one’s choices were honored and less likely to have regrets about how the loved one died. Comparing family members of those who requested aid in dying to those who did not revealed no differences in primary mental health outcomes of depression, grief, or mental health services use. Family members of Oregonians who requested aid in dying felt more prepared and accepting of the death than comparison family members. In summary, pursuit of aid in dying does not have negative effects on surviving family members and may be associated with greater preparation and acceptance of death.

Key WordsEuthanasia, family, outcomes

a Portland Center for the Study of Chronic, Comorbid Mental and Physical Disorders, Health Services Research and Development, Research Service (R&D 66), Portland Veterans Affairs Medical Center, Portland, Oregon, USA

b Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA

c Center for Psycho-Oncology and Palliative Care Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA

d Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA

Corresponding Author InformationAddress correspondence to: Linda Ganzini, MD, MPH, Portland Center for the Study of Chronic, Comorbid Mental and Physical Disorders, Health Services Research and Development, Research Service (R&D 66), Portland Veterans Affairs Medical Center, P.O. Box 1034, Portland, OR 97239, USA.

 E. R. G. and S. K. D. are Department of Veterans Affairs Health Services Research and Development, Research Career Development awardees. This study was funded by the Greenwall Foundation and the Department of Veterans Affairs.

 The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government.

PII: S0885-3924(09)00707-6

doi:10.1016/j.jpainsymman.2009.04.026


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