"A Better Death" for Hospice Patients Ganzini L, Goy ER, Miller LL, et al. Nurses' experiences with hospice patients who refuse food and fluids to hasten death. N Engl J Med. 2003; 349:359-365. In Oregon, where physician-assisted suicide is legal, a surprising number of older terminally ill patients choose discontinuing food and fluids as a means to avoid prolonging life. According to researchers who published the results of a survey of Oregon hospice nurses in the New England Journal of Medicine, 102 of 429 respondents said at least one of their patients had hastened death in this way during the previous four years (1997 to 2001). Meanwhile, 55 of these nurses' terminally ill patients used legally prescribed narcotics to hasten death. When Ganzini and colleagues compared nurse-reported data for these two groups of patients, they found that those who stopped eating and drinking were older than members of the physician-assisted suicide group, were more likely to have a neurologic disease than cancer, and were less likely to have undergone a mental health evaluation. Patients' most important reasons for stopping food and fluids included readiness to die, poor quality of life, and the wish to die at home. Patients requesting physician-assisted suicide were more likely to mention wanting control over the time and manner of their death. Eighty-five percent of the patients who stopped eating and drinking died within 15 days of their decision. When the surveyed nurses were asked to rate their patients' quality of death (from 0 representing a very bad death to 9 for a very good death), the median score was 8. Although 8% of patients' deaths were rated 0 to 4 in quality, most patients were described as "suffering less and being more at peace" than patients who opted for physician-assisted suicide. The investigators surveyed nurses caring for Oregon residents who are enrolled in Medicare-certified home hospice programs. Responses were coded for anonymity. Each nurse was asked (if applicable) to report on the patient who most recently "voluntarily and deliberately [stopped] all food and fluids with the primary intention of hastening death." Nearly identical questions were asked about patients who died after receiving a prescribed lethal medication. Clinician Reviews 13(9):39-40, 2003. Thanks to Medscape.com, 10/03 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.