Attitudes of elderly patients and their families toward physician-assisted suicide

OBJECTIVES: To examine and compare attitudes of elderly outpatients their families toward physician-assisted suicide (PAS), explore and health correlates of these attitudes, assess family' ability to predict patients' attitudes toward PAS, and determine members' ability to agree on these predictions. SUBJECTS AND METHODS: patients with medical and psychiatric problems (n = 168; mean age,75.8 years) who were attending a geriatrics specialty clinic, along with family members (n = 146), were systematically surveyed on their toward PAS in case of terminal illness, chronic illness, and mental. Relatives were also asked to predict patients' responses to on the questionnaire. Patients and relatives were blinded to each' responses. RESULTS: Favorable attitudes toward PAS were reported by39.9% of the patients and 59.3% of the relatives (P less than .001) in case of illness, 18.2% and 25.3%, respectively, in case of chronic illness,13.5% and 15.4%, respectively, in case of mental incompetence, and 34.0% and55.6% (P less than .001), respectively, for legalization of PAS. Family showed a marginal ability to predict patients' attitudes toward PAS kappa values of agreement that ranged from 0.09 to 0.41. Family members had difficulty agreeing with each other on how they thought patients respond (range of kappa values, 0.18-0.47). Patients who opposed PAS women, black individuals, and those with less education, low incomes, and or cognitive impairment. CONCLUSIONS: While many frail elderly favored PAS in cases of terminal illness, the proportion that opposed was significantly higher than that among relatives; relatives, in turn, only a marginal ability either to predict patients' attitudes or to among themselves. Patients who oppose PAS represent a particularly element of society (elderly persons, women, black individuals, and, uneducated, and demented persons), and such patients may warrant special.