Ganzini L, Johnston W S, McFarland B H, Tolle S W, Lee M A
Department of Psychiatry, Center for Ethics in Health Care, Oregon Health Sciences University, Portland Veterans Affairs Medical Center, 97207, USA.
N Engl J Med. 1998 Oct 1;339(14):967-73. doi: 10.1056/NEJM199810013391406.
Amyotrophic lateral sclerosis (ALS) is a neuromuscular disease that causes gradual paralysis, respiratory failure, and death, usually within three to five years after it has been diagnosed. Between 1995 and 1997, we surveyed patients with this disease in Oregon and Washington, as well as their family care givers, in order to determine their attitudes toward assisted suicide. Patients were considered to be willing to contemplate assisted suicide if they agreed with the statement, "Under some circumstances I would consider taking a prescription for a medicine whose sole purpose was to end my life," and disagreed with the statement, "I would never request or take a prescription for a medication whose sole purpose was to end my life." The Oregon Death with Dignity Act, which legalized physician-assisted suicide, was approved by Oregon voters in 1994 but did not go into effect until October 1997, after data collection for this study had been completed.
Of 140 eligible persons with ALS, 100 (71 percent) agreed to participate in the study, as did 91 family care givers. The mean age of the patients with ALS was 54 years; the mean duration of illness since the diagnosis was 2.8 years. Fifty-six patients (56 percent) said they would consider assisted suicide, and 44 of the 56 agreed with the statement, "If physician-assisted suicide were legal, I would request a lethal prescription from a physician." One patient would have taken the medication immediately, and 36 would have kept it for future use. As compared with the patients who were opposed to assisted suicide, those who would consider it were more likely to be men, had a higher level of education, were less likely to be religious, had higher scores for hopelessness, and rated their quality of life as lower. In 66 of 91 instances (73 percent), care givers and patients had the same attitude toward assisted suicide.
In Oregon and Washington, a majority of persons with ALS whom we surveyed would consider assisted suicide. Many would request a prescription for a lethal dose of medication well before they intended to use it.
肌萎缩侧索硬化症（ALS）是一种神经肌肉疾病，会导致逐渐瘫痪、呼吸衰竭并最终死亡，通常在确诊后的三到五年内发生。1995年至1997年间，我们对俄勒冈州和华盛顿州的该疾病患者及其家庭护理人员进行了调查，以确定他们对协助自杀的态度。如果患者同意“在某些情况下，我会考虑开具一种唯一目的是结束我生命的药物的处方”这一说法，并且不同意“我永远不会要求或服用一种唯一目的是结束我生命的药物的处方”这一说法，则被认为愿意考虑协助自杀。俄勒冈州的《尊严死亡法案》使医生协助自杀合法化，该法案于1994年得到俄勒冈州选民的批准，但直到1997年10月才生效，此时本研究的数据收集工作已经完成。
在140名符合条件的ALS患者中，100名（71%）同意参与研究，91名家庭护理人员也同意参与。ALS患者的平均年龄为54岁；自诊断以来的平均病程为2.8年。56名患者（56%）表示他们会考虑协助自杀，其中44名同意“如果医生协助自杀合法，我会向医生请求开具致命处方”这一说法。一名患者会立即服用该药物，36名患者会留作未来使用。与反对协助自杀的患者相比，考虑协助自杀的患者更可能是男性，受教育程度更高，宗教信仰较少，绝望得分更高，并且对生活质量的评价更低。在91例情况中的66例（73%）中，护理人员和患者对协助自杀的态度相同。
在俄勒冈州和华盛顿州，我们调查的大多数ALS患者会考虑协助自杀。许多人会在打算使用之前很久就请求开具致命剂量药物的处方。
