Patients who desire euthanasia or assisted suicide apparently view these options as a means of limiting feelings of loss of self, according to a study of HIV patients.

To assess patient attitudes toward life ending measures, Canadian researchers interviewed 32 people with HIV/ AIDS, most of whom had decided to pursue euthanasia or assisted suicide.

Two main factors influencing the decision to end life emerged. The first was ‘disintegration’, when a patient begins to experience symptoms and loss of function. The second was ‘loss of community’, when the patient has fewer and fewer opportunities to initiate and maintain close personal relationships. These factors contribute to a perceived loss of self which the patients felt could only be remedied through euthanasia.

Most research into euthanasia focuses on the attitudes and opinions of physicians and the general public, and the ethics of helping someone to die. This unusual study of patients’ views found that there comes a point when terminally ill patients begin to feel non human. In this study, patients in this state referred to themselves as a ‘doll’ or ‘a bag of potatoes’.

In a related editorial, Drs A.L. Back and R.A. Pearlman, of the University of Washington, Seattle, commented that exploring the issue of physician assisted suicide opens a “window into a particular set of concerns that patients have about dying, relating to loss of self, loss of dignity, and the social context of dying” (Lancet, 2001; 358: 362-7, 344-5).

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Written by What Doctors Don't Tell You

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