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Stanford University School of Medicine

Stanford study finds support in California and Hawaii for physician-assisted death

In 2015, just as the California legislature was voting whether to allow physicians to prescribe lethal medication to terminally ill patients, Stanford researchers launched an online survey of their own on the controversial issue. Hoping to better understand the attitudes of ethnically diverse populations, palliative care experts distributed the survey to residents of California and Hawaii asking whether they supported physician-assisted death.

Today, the day the law takes effect legalizing physician-assisted death, the results of the survey were published in the Journal of Palliative Medicine. They show support across ethnic groups by a majority of respondents, with older Americans showing greatest support and the most religious or spiritual people the least support. But even among those who declared that religion or spirituality was very important to them, a majority still supported the practice.

Our release reported the results:

Among the 1,095 responses from California and 819 from Hawaii, the majority -- both in California (72.5 percent) and Hawaii (76.5 percent) -- were supportive of physician-assisted death.

"Older participants were more supportive of physician-assisted death compared with their younger counterparts in both states," the study said. "Persons who reported that spirituality was less important to them were more likely to support PAD in both states."

Senior and lead author of the study VJ Periyakoil, MD, a clinical associate professor of medicine at Stanford, said she was surprised that a majority of all ethnic groups supported physician-assisted death. But even more surprising was the study's finding that a majority of the most religious respondents were supportive. As our release explains:

"It is remarkable that in both states, even participants who were deeply spiritual (52 percent) were still in support of physician-assisted death," said the study. "Both genders and all racial/ethnic groups in both states were equally in support of PAD."

"The response was surprisingly positive across all ethnic groups," said Periyakoil. Those taking the survey marked their ethnicities as African American, Latino, white, Native Hawaiian/Pacific Islander or Asian.

"I was surprised that people who were deeply spiritual were still positive overall," she added.

Periyakoil, an expert on end-of-life care and director of the Stanford Palliative Care Education and Training Program, stressed that it's important for physicians in California to prepare for the new law by training in end-of-life conversations and by being aware of cultural differences. As she said in the release, physicians need to be honest with their patients:

"Just be upfront," she said. "Tell patients, 'Listen, this is a very hard topic for all of us.'

"It takes a tremendous amount of courage on the patient's part to ask these questions," Periyakoil said. "How the doctor responds initially to the patient's question is very important and will set the tone for the rest of the interaction about this sensitive issue."

To help with this transition, Periyakoil has posted a teaching module on physician-assisted death on the medical school's website, for both patients and physicians.

Previously: Call to improve quality and honor individual preferences at the end of life, The importance of patient-doctor end-of-life discussions, KQED health program focuses on end-of-life care and Facing mortality
Photo by danigeza

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