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Am J Psychiatry 1996; 153:238-242
Copyright © 1996 by American Psychiatric Association
Interest in physician-assisted suicide among ambulatory HIV-infected patients
W Breitbart, BD Rosenfeld and SD Passik
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
OBJECTIVE: This study surveyed HIV-infected patients' attitudes toward
physician-assisted suicide and examined the relationship between interest
in physician-assisted suicide and physical and psychosocial variables.
METHOD: Three hundred seventy-eight ambulatory HIV-infected patients, 90%
of whom met the criteria of the Centers for Disease Control for AIDS, were
recruited from several sites in New York City. Self-report measures were
used to assess pain, physical symptoms, psychological distress, depression,
and social supports. Attitudes toward, and interest in, physician-assisted
suicide were assessed through responses to a questionnaire. RESULTS:
Sixty-three percent of the patients supported policies favoring
physician-assisted suicide, and 55% acknowledged considering
physician-assisted suicide as an option for themselves. The strongest
predictors of interest in physician-assisted suicide were high scores on
measures of psychological distress (depression, hopelessness, suicidal
ideation, overall psychological distress) and experience with terminal
illness in a family member or friend. Other strong predictors were
Caucasian race, infrequent or no attendance at religious services, and
perceived low level of social supports. Interest in physician-assisted
suicide was not related to severity of pain, pain-related functional
impairment, physical symptoms, or extent of HIV disease. CONCLUSIONS:
HIV-infected patients supported policies favoring physician-assisted
suicide at rates comparable to those in the general public. Patients'
interest in physician-assisted suicide appeared to be more a function of
psychological distress and social factors than physical factors. These
findings highlight the importance of psychiatric and psychosocial
assessment and intervention in the care of patients who express interest in
or request physician-assisted suicide.
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