请求安乐死的原因。

Reasons for requesting medical assistance in dying.

机构信息

Clinical Professor in the Department of Family Practice at the University of British Columbia in Vancouver and a family physician who practises in women's health and assisted death.

Assistant Professor in the Faculty of Social Work at the University of Calgary in Alberta.

出版信息

Can Fam Physician. 2018 Sep;64(9):674-679.

PMID:30209101

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6135145/

Abstract

OBJECTIVE

To review the charts of people who requested medical assistance in dying (MAID) to examine their reasons for the request.

DESIGN

Retrospective chart survey.

SETTING

British Columbia.

PARTICIPANTS

Patients who requested an assisted death and were assessed by 1 of 6 physicians in British Columbia during 2016.

MAIN OUTCOME MEASURES

Patients' diagnoses and reasons for requesting MAID.

RESULTS

Data were collected from 250 assessments for MAID: 112 of the patients had assisted deaths, 11 had natural deaths, 35 were assessed as not eligible for MAID, and most of the rest were not ready. For people who had assisted deaths, disease-related symptoms were given as the first or second most important reason for requesting assisted death by 67 people (59.8%), while 59 (52.7%) gave loss of autonomy, 55 (49.1%) gave loss of ability to enjoy activities, and 27 (24.1%) gave fear of future suffering. People who were assessed as eligible but who had not received assisted deaths were more likely to list fear of future suffering (33.7% vs 7.1%) and less likely to list disease-related symptoms (17.4% vs 40.2%) than those who received MAID were. There was a difference in reasons for MAID given by people with different diagnoses; disease-related symptoms were given as the most important reason by 39.0% of patients with malignancies, 6.8% of patients with neurological diseases, and 28.9% of patients with end-organ failure. Loss of autonomy was given as the most important reason by 16.0% of patients with malignancies, 36.4% of patients with neurological diseases, and 23.7% of patients with end-organ failure.

CONCLUSION

This study shows that the reasons patients give for requesting an assisted death are similar to those reported in other jurisdictions with similar laws, but in different proportions. Loss of autonomy and loss of ability to enjoy activities were less common reasons among patients in this study compared with other jurisdictions. This might be related to the method of data collection, as in this study, the patients' reasons were recorded by physicians.

摘要

目的

回顾请求协助死亡（MAID）的患者的病历，以检查他们提出请求的原因。

设计

回顾性病历调查。

地点

不列颠哥伦比亚省。

参与者

2016 年期间，不列颠哥伦比亚省的 6 名医生评估的请求协助死亡的患者。

主要观察指标

患者的诊断和请求 MAID 的原因。

结果

共收集了 250 例 MAID 评估数据：112 名患者进行了协助死亡，11 名患者自然死亡，35 名患者被评估为不符合 MAID 条件，其余大多数患者尚未准备好。对于进行了协助死亡的人，67 人（59.8%）将疾病相关症状列为请求协助死亡的第一或第二重要原因，而 59 人（52.7%）将失去自主权，55 人（49.1%）将失去享受活动的能力，27 人（24.1%）将对未来痛苦的恐惧列为原因。被评估为符合条件但尚未接受协助死亡的人比接受 MAID 的人更有可能列出对未来痛苦的恐惧（33.7%比 7.1%），而不太可能列出与疾病相关的症状（17.4%比 40.2%）。不同诊断的患者列出的 MAID 原因存在差异；恶性肿瘤患者中有 39.0%将与疾病相关的症状列为最重要的原因，神经疾病患者中有 6.8%，终末器官衰竭患者中有 28.9%。失去自主权被 16.0%的恶性肿瘤患者、36.4%的神经疾病患者和 23.7%的终末器官衰竭患者列为最重要的原因。