Trends in End-Of-Life Concerns after the Legalization of Assisted Suicide

Abstract

Background: Understanding the concerns that motivate requests for euthanasia or assisted suicide is essential for understanding these practices.  In this paper, we use data from official reports from Oregon and Washington to estimate trends in these concerns.

Method: We estimate regressions using each end-life-concern (Autonomy, Enjoyment, Dignity, Control, Pain and Finance) as a separate dependent variable. We pool the data for our two states and estimate the trend for each end-of-life concern. We add controls for demographic variables.  For robustness we estimate separate time trends for each state; control using OLS rather than logistic regression; exclude the final year of observations; and allow for non-linear trends.

Results: Our estimates suggest no significant trend for Autonomy or Enjoyment.  The trend is negative and statistically significant for Dignity and Control and significantly positive for Burden, Pain, and Finance.  Including covariates does not change the pattern of significance.  The trend for Control is significantly negative only for Oregon.  There is also evidence of a non-linear effect in the cases of Control and Burden.

Conclusion: There have been significant trends in some end-of-life concerns that motivate requests for assisted suicide in Oregon and Washington.  Increases in concern about being a burden to others and in financial concerns are statistically significant.  Qualitative research has identified adverse impacts of assisted dying on pain management.  This research shows a significant increase in concerns about inadequate pain control since legalization of assisted suicide in Oregon and Washington.

Keywords: Assisted suicide, assisted dying, end of life concerns