Prevalence of depression and anxiety in patients requesting physicians' aid in dying: cross sectional survey

doi:10.1136/bmj.a1682

Published 8 October 2008, doi:10.1136/bmj.a1682
Cite this as: BMJ 2008;337:a1682

Research

Prevalence of depression and anxiety in patients requesting physicians’ aid in dying: cross sectional survey

Linda Ganzini, professor¹^,2, Elizabeth R Goy, assistant professor ¹^,2, Steven K Dobscha, associate professor¹^,2

¹ Columbia Center for the Study of Chronic, Comorbid Mental and Physical Disorders, Health Services Research and Development, Portland Veterans Affairs Medical Center, PO Box 1034, Portland, OR 97239, USA, ² Department of Psychiatry, Oregon Health and Science University

Correspondence to: Linda Ganzini Linda.Ganzini{at}va.gov

Objective To determine the prevalence of depression and anxietyin terminally ill patients pursuing aid in dying from physicians.

Design Cross sectional survey.

Setting State of Oregon, USA.

Participants 58 Oregonians, most terminally ill with canceror amyotrophic lateral sclerosis, who had either requested aidin dying from a physician or contacted an aid in dying advocacyorganisation.

Main outcome measures Diagnosis of depression or anxiety accordingto the hospital anxiety and depression scale and the structuredclinical interview for the Diagnostic and Statistical Manualof Mental Disorders.

Results 15 study participants met "caseness" criteria for depression,and 13 met criteria for anxiety. 42 patients died by the endof the study; 18 received a prescription for a lethal drug underthe Death with Dignity Act, and nine died by lethal ingestion.15 participants who received a prescription for a lethal drugdid not meet criteria for depression; three did. All three depressedparticipants died by legal ingestion within two months of theresearch interview.

Conclusion Although most terminally ill Oregonians who receiveaid in dying do not have depressive disorders, the current practiceof the Death with Dignity Act may fail to protect some patientswhose choices are influenced by depression from receiving aprescription for a lethal drug.

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