Interest in physician-assisted suicide among ambulatory HIV-infected patients

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Abstract
This study surveyed HIV-infected patients' attitudes toward physician-assisted suicide and examined the relationship between interest in physician-assisted suicide and physical and psychosocial variables. Three hundred seventy-eight ambulatory HIV-infected patients, 90% of whom met the criteria of the Centers for Disease Control for AIDS, were recruited from several sites in New York City. Self-report measures were used to assess pain, physical symptoms, psychological distress, depression, and social supports. Attitudes toward, and interest in, physician-assisted suicide were assessed through responses to a questionnaire. Sixty-three percent of the patients supported policies favoring physician-assisted suicide, and 55% acknowledged considering physician-assisted suicide as an option for themselves. The strongest predictors of interest in physician-assisted suicide were high scores on measures of psychological distress (depression, hopelessness, suicidal ideation, overall psychological distress) and experience with terminal illness in a family member or friend. Other strong predictors were Caucasian race, infrequent or no attendance at religious services, and perceived low level of social supports. Interest in physician-assisted suicide was not related to severity of pain, pain-related functional impairment, physical symptoms, or extent of HIV disease. HIV-infected patients supported policies favoring physician-assisted suicide at rates comparable to those in the general public. Patients' interest in physician-assisted suicide appeared to be more a function of psychological distress and social factors than physical factors. These findings highlight the importance of psychiatric and psychosocial assessment and intervention in the care of patients who express interest in or request physician-assisted suicide.