US doctors handle suicide requests alone

US doctors handle suicide requests alone - study
REUTERS

MAR 14: Doctors whose terminally ill patients ask for help in ending their lives are often forced by an "unspoken code of silence" to decide on the request alone, without the advice of fellow physicians, researchers said on Tuesday.

In a study published in the Archives of Internal Medicine, researchers interviewed doctors in Seattle and San Francisco who had received at least one request from a terminally ill patient for help in committing suicide. Half of the doctors had helped a patient to die, while the other half had not.

Dr. Jeffrey Kohlwes, who led the study, said the most surprising finding was that doctors rarely discussed the suicide requests with other doctors.

"Most physicians who received these requests really dealt with them alone. They perceived an unspoken code of silence on the topic amongst their colleagues," Kohlwes, a doctor at San Francisco Veterans Affairs Medical Center and a professor at the University of California San Francisco, said in a statement.

Although doctor-assisted suicide is against the law in every US state but Oregon, doctors who care for terminally ill patients regularly hear suicide requests from patients, the researchers said. But there has been little documentation of how these requests are handled, they said.

The study was based on interviews with 20 doctors.

A heavy emotional burden accompanied the isolation experienced by the doctors, Kohlwes said. A few said they were worried about becoming known publicly as the "local Kevorkian," Kohlwes said, referring to Dr. Jack Kevorkian, an assisted-suicide crusader convicted in 1999 of second-degree murder in Michigan.

Doctors said they had the most difficulty dealing with requests from patients who wanted to die because their lives had become devoid of meaning, not because they were undergoing unbearable pain or suffering.

Kohlwes said most requests for a doctor's help in suicide could be handled by simply treating physical pain or depression.

"Most physicians we interviewed used these requests as a warning flag to aggressively treat a patient's physical discomfort, and in many cases they felt this was effective," he said. Most doctors in the study reported treating their patients with antidepressants.