 |
|
Informal Caregivers and the Intention to Hasten AIDS-Related Death
Molly Cooke, MD;
Linda Gourlay, MSN;
Linda Collette, MS;
Alicia Boccellari, PhD;
Margaret A. Chesney, PhD;
Susan Folkman, PhD
Arch Intern Med. 1998;158:69-75.
Objectives To determine the extent to which homosexual men dying of the acquired immunodeficiency syndrome (AIDS) receive medication intended to hasten death. To assess the impact on caregivers of administering medications intended to hasten death.
Methods In a prospective study of caregiving partners of men with AIDS (n=140), characteristics of the ill partner, the caregiver, and the relationship were assessed at baseline and 1 month before the ill partner's death. Three months after the death, caregivers were asked if they had increased their partner's narcotic and/or sedative-hypnotic medication dose and if so, what had been the objective of the increase, and their comfort with their medication decisions.
Results Of 140 ill partners who died of AIDS, 17 (12.1%) received an increase in the use of medications immediately before death intended to hasten death. Diagnoses and care needs of ill partners who received increases in the use of medications to hasten death did not differ from those of ill partners receiving medication for symptoms. Fourteen increases (10%) in use of medications were administered by caregivers. These caregivers did not differ from those administering medication for symptom control in level of distress, caregiving burden, relationship characteristics, or comfort with the medication decision, but they reported more social support and positive meaning in caregiving.
Conclusion The decision to hasten death is not a rare event in this group of men. There is no evidence that it is the result of caregiver distress, poor relationship quality, or intolerable caregiving burden; and it does not cause excessive discomfort in the surviving partner. This study, although small, has implications for the policy debate on assisted suicide.
From the Department of Medicine (Drs Cooke, Chesney, and Folkman) and Center for AIDS Prevention Studies (Drs Cooke, Chesney, and Folkman and Mss Gourlay and Collette), University of California at San Francisco, and the Department of Psychiatry, San Francisco General Hospital (Dr Boccellari).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Wish to die in end-stage ALS
Albert et al.
Neurology 2005;65:68-74.
ABSTRACT
| FULL TEXT
A Primer on Rational Suicide and Other Forms of Hastened Death
Werth and Holdwick
The Counseling Psychologist 2000;28:511-539.
ABSTRACT
|
