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This list of peer-reviewed journal articles about physician-assisted dying and related issues is organized by topic:

For books on Death with Dignity and related end-of-life issues, click here.

Implementation of Death with Dignity Legislation

“Drug Price Inflation and the Cost of Assisted Death for Terminally Ill Patients—Death With Indignity,” October 6, 2016. Veena Shankaran, MD, MS;Richard J. LaFrance, PharmD; and Scott D. Ramsey, MD, PhD. JAMA Oncology.

Authors review the use of the Washington State Death with Dignity Act since 2009. The number of prescriptions dispensed in Washington State has steadily increased, and the majority of patients to whom the medications have been dispensed have ingested them. The law has generally been considered successful and patients have reported feeling grateful to have an option for physician-assisted death. However, patients and their families are raising new concerns about the high cost of medication and the unaffordability of ending their lives in this way.

“When a Patient Discusses Assisted Dying: Nursing Practice Implications.” July 2016. Rebecca H. Lehto; Douglas P. Olsen; Roxanne Raffin Chan. Journal of Hospice and Palliative Nursing, Vol. 18, No. 3, pp. 184-191.

“Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the United States, Canada, and Europe.” July 2016. Ezekiel J. Emanuel, Bregje D. Onwuteaka-Philipsen, John W. Urwin, Joachim Cohen. JAMA, Vol. 316, No. 1 [Summary by Science Daily]

“Legalised Physician-Assisted Death in Oregon.” January 2016. Linda Ganzini. QUT Law Review, Vol. 16, No. 1, pp 76-83 [pdf]

Ganzini reviews the Oregon Death with Dignity Act by discussing what the collected data present. She concludes that legalization of physician-assisted dying has not decreased the use of or quality of palliative and hospice care. She also addresses other concerns about the law, including mental illness and depression, and shows that there is much support for greater psychiatric involvement to evaluate patients for depression. However, it is unclear whether mandatory psychiatric evaluations would benefit and protect vulnerable patients and psychiatrists. Overall, the data show a slight increase in use of aid in dying over time; that the large majority of patients using the life-ending medication have similar terminal illnesses; and that patients are educated, insured, and mentally competent.

“Clinical Criteria for Physician Assisted Aid in Dying.” November 2015. David Orentlicher, MD, JD, Thaddeus Mason Pope, JD, PhD, & Ben A. Rich, JD, PhD. Journal of Palliative Medicine, Vol. 18, No. X, pp. 1-4.

Authors discusse the main areas in which the Physician Aid-in-Dying Clinical Criteria Committee deemed most important for physicians to focus on when a patient requests aid-in-dying. First, they express the importance of determining if the request is voluntary, informed, and without influence of others or of mental illness. Secondly, they asses whether the patient thoroughly understands his/her options for end-of-life carem such as hospice, stopping eating/drinking, and palliative sedation. Third, they assert that physicians must make clear the results of ingesting the life-ending medication and must be thorough in documenting the patient’s understanding through the process of requesting. Lastly, the Committee urges patients to have family present and discusses the steps of how to ingest the medications for the safest possible death.

“Implementing a Death with Dignity Program at a Comprehensive Cancer Center.” April 11, 2013. Elizabeth Trice Loggers, Helene Starks, Moreen Shannon-Dudley, Anthony L. Back, Frederick R. Appelbaum, and F. Marc Stewart. New England Journal of Medicine, Vol. 368, No. 15, pp. 1417-1424.

This article provides an institutional response to Death with Dignity through the perspective of a Washington cancer center. The cancer center found that their Death with Dignity program showed data consistent with the overall Death with Dignity data collected in Oregon and Washington. This institution’s Death with Dignity program has elicited positive responses from physicians, patients, and families. They attribute this acceptance to the professional leadership team at the cancer center who provide great care in prescribing and consulting patients in the end-of-life process.

“Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey.” July 11, 2012, published online. Bregje D. Onwuteaka-Philipsen, Arianne Brinkman-Stoppelenburg, Corine Penning, Gwen JF de Jong-Krul, Prof Johannes JM van Delden, Agnes van der Heide. The Lancet.

“The Washington State Death With Dignity Act: A Survey of Nurses Knowledge and Implications for Practice Part 1.” January/February 2012. Anita Jablonski, Janine Clymin, Dana Jacobson, Karen Feldt. Journal of Hospice & Palliative Nursing, Vol. 14, No. 1, pp. 45–52.

“Legal physician-assisted dying in Oregon and the Netherlands: The question of “vulnerable” groups. A reply to I.G. Finlay and R. George.” July, 27 2011. Margaret P. Battin, Agnes van der Heide, Linda Ganzini, Gerrit van der Wal, Bregje D. Onwuteaka. Journal of Medical Ethics, Vol. 37, No. 3, pp. 171174.

This article defends the data the authors collected and refutes Finlay and George’s argument that being in the position to request physician assisted death makes one vulnerable by nature. The authors argue that the way opposers of physician assisted death define vulnerable groups is different than how they have in their studies because they recognize all types of “vulnerable” groups, not just the ten most common groups that Finlay and George identify. They argue that Finlay and George’s critique of their data merely reflects the limitations of their study.

“Quality of Death and Dying in Patients Who Request Physician-Assisted Death.” April 6, 2011. Kathryn A. Smith, Elizabeth R. Goy, Theresa A. Harvath and Linda Ganzini. Journal of Palliative Medicine, Vol. 14, No. 4, pp. 445-450.

“Mental Health Outcomes of Family Members of Oregonians Who Request Physician Aid in Dying.” December 2009. Linda Ganzini, Elizabeth R. Goy, Steven K. Dobscha, Holly Prigerson. Journal of Pain and Symptom Management, Vol. 38, No. 6, pp. 807-815.

This study shows that aid in dying does not have negative grief impacts on family members of the deceased and may lead to a more prepared death. In contrast, family members who’s loved one did not pursue aid in dying expressed feelings of regret that the deceased did not fulfill their wishes. Family members of aid in dying also reported a higher quality of life rating in the last week of life than those who did not request aid in dying. Furthermore, this study shows that aid in dying does not result in prolonged mental health or severe grief symptoms among family members.

“The Inevitable Death: Oregon’s End-of-Life Choices.” November 18, 2008. Ann Jackson. Willamette Law Review, Vol. 45, No. 1, pp. 137-160.

“Prevalence of depression and anxiety in patients requesting physicians’ aid in dying: cross sectional survey.” 2008. Linda Ganzini, Elizabeth R Goy & Steven K Dobscha. The BMJ (British Medical Journal). Vol. 337, pp. 1-5.

“Why Oregon Patients Request Assisted Death: Family Members’ Views.” February, 2008. Linda Ganzini, Elizabeth R. Goy, and Steven K. Dobscha. Journal of General Internal Medicine, Vol. 23, No. 2, pp. 154-157.

“Legal Physician-Assisted Dying in Oregon and the Netherlands: Evidence Concerning the Impact on Patients in “Vulnerable” Groups.” October, 2007. Margaret P Battin, Agnes van der Heide, Linda Ganzini, Gerrit van der Wal, Bregje D Onwuteaka-Philipsen. Journal of Medical Ethics, Vol. 33, No. 10, pp. 591-597.

Oregon Hospice Chaplains’ Experiences with Patients Requesting Physician-Assisted Suicide.” December 13, 2005. Bryant Carlson, Nicole Simopolous, Elizabeth R. Goy, Ann Jackson, Linda Ganzini. Journal of Palliative Medicine, Vol. 8, No. 6, pp. 1160-1166.

“Characteristics of Patients Requesting and Receiving Physician-Assisted Death.” July 14, 2003. Diane E. Meier, Carol-Ann Emmons, Ann Litke, Sylvan Wallenstein, and R. Sean Morrison. Archive of Internal Medicine, Vol. 163, No. 13, pp. 1537-1542.

“Interest in Assisted Suicide Among Oregon Cancer Patients.” April 2003. Linda Ganzini, Tomasz M. Beer, and Matthew Brouns. Oregon Health Sciences University.

“Physicians’ Experiences with the Oregon Death with Dignity Act.” February 2000. Linda Ganzini et al. New England Journal of Medicine, Vol. 342, No. 8, pp. 557-563 [pdf]

“Legalized Physician-Assisted Suicide in Oregon, 1998-2000.” February 22, 2001. Amy D. Sullivan, Katrina Hedberg, and David Hopkins New England Journal of Medicine, Vol. 344, No. 8, pp. 605-607.

“Physician-Assisted Suicide and Patients with Human Immunodeficiency Virus Disease.” February 6, 1997. Lee R. Slome, Thomas F. Mitchell, Edwin Charlebois, Jeffrey Moulton Benevedes, and Donald I. Abrams. New England Journal of Medicine, Vol. 336, No. 6, pp. 417-421.

Healthcare Professionals on Death with Dignity

Legal Challenges

End of Life Care

Palliative Sedation and Voluntary Refusal of Treatment or Food & Fluids

Physician-Assisted Death and People with Disabilities

  • “The Ethics of PAS: Morally Relevant Relationships Between Personal Assistance Services and Physician-Assisted Suicide.” 2001. Andrew I. Batavia. Archives of Physical Medicine and Rehabilitation, Vol. 12, Suppl. 2, pp. 25-31.
  • “So Far, So Good: Observations on the First Year of the Oregon Death with Dignity Act.” 2000. Andrew I. Batavia. In: Special Theme Issue: Hastened Death. G. Andrew H. Benjamin, James L. Werth, Jr, and Lawrence Gostin, eds. Psychology, Public Policy and Law, Vol. 6, No. 2, pp. 291-305.
  • “The Relevance of Physician and Disability Data on the Right to Physician-Assisted Suicide: Can Studies Resolve the Issue?” 2000. Andrew I. Batavia. In: Special Theme Issue: Hastened Death. G. Andrew H. Benjamin, James L. Werth, Jr, and Lawrence Gostin, eds. Psychology, Public Policy and Law, Vol. 6, No. 2, pp. 546-558.
  • “Disability and Physician-Assisted Suicide.” June 1997. Andrew I. Batavia. The New England Journal of Medicine, Vol. 336, No. 23, pp. 1671-73.
  • “A Disability Rights/Independent Living Perspective on Euthanasia.” May 1991. Andrew I. Batavia. The Western Journal of Medicine, Vol. 154, pp. 616-7.