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Amyotrophic Lateral Sclerosis Patients Ask Doctors For Suicide Help
New England Journal of Medicine (NEJM)
05/23/2002
By Anne MacLennan
One in five amyotrophic lateral sclerosis (ALS) patients in the Netherlands dies of doctor-assisted suicide or euthanasia, a study there has found.
Jan H. Veldink and colleagues from University Medical Center, Utrecht, and Vrije Universiteit Medical Center and Academic Medical Center, both in Amsterdam, led this study of 279 patients with ALS who died between 1994 and 1999.
Of 241 eligible doctors, 203 (84 percent) completed and returned a validated questionnaire about end-of-life decisions made by the patients.
The results showed that 35 (17 percent) of the patients chose and died from euthanasia and six patients (3 percent) died by doctor-assisted suicide. Patients to whom religion was important were less likely to have died as a result of euthanasia or doctor-assisted suicide.
Choice of one or the other method of dying was not linked with any particular characteristics of the disease or of the patient's care, nor was it associated with income or educational level.
Of patients who died as a result of euthanasia versus those who died in other ways, disability before death was significantly more severe. Doctor-assisted suicide appeared to occur earlier in the course of the disease than did euthanasia.
An additional 48 patients (24 percent) received palliative treatment, which probably shortened their lives.
N Engl J Med 2002;346:1638-1644.
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