Pursuit of assisted dying: a pilot study of inquiries made to a national consumer-based organization

Legal developments in assisted dying have focused on assisted suicide for mentally competent, terminally ill adults. Requests for assisted dying are likely to represent broader concerns, but studies have been limited to surveys of specific patient groups or recollections of physicians. To describe the nature of inquiries by a broad range of persons seeking assisted dying, a retrospective review was performed of confidential client memoranda summarizing telephone inquiries regarding assisted dying to a counseling service of a national, not-for-profit, consumer-based organization. The review evaluated the underlying medical condition prompting the inquiry, evidence of patient's decisional capacity, and relationship of caller to the patient. Of 125 assisted suicide calls, 111 with medical illness were analyzed. Among 111 inquiries, 71 (64%) were made by someone other than the person suffering from the illness ("the patient"); 52 (47%) of these were family members, 14 (13%) were friends, and 5 (7%) were professionals. Cancer accounted for 25% of cases, HIV/AIDS and amyotrophic lateral sclerosis (ALS) for 10 and 9%, respectively, other neurological diseases for 23%, and chronic or other medical conditions for approximately 17%. In an additional 10 cases, there was no medical illness. Within the group of callers inquiring on behalf of others, 18 (25%) stated the patient lacked ability to communicate his or her wishes and 7 (10%) stated there was uncertainty. Inquiries about assisted dying represent a broader range of concerns than represented by legal initiatives. More study is needed to determine if enhanced knowledge about alternatives, such as palliative care, reduces requests for assisted dying.