ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO1698

Attitudes Towards Physician-Assisted Death in Patients Receiving Maintenance Dialysis

Session Information

Category: Geriatric Nephrology

  • 1100 Geriatric Nephrology

Authors

  • Saeed, Fahad, University of Rochester Medical Center, Rochester, New York, United States
  • Kazi, Basil S., University of Rochester Medical Center, Rochester, New York, United States
  • Mayo, Nicole Lynn, University of Rochester, Rochester, New York, United States
Background

During recent years, the debate about the legalization of physician-assisted death (PAD) has intensified at both public and policy levels. Surveys and polls on this issue have included seriously ill patients such as those with cancer; however, voices of patients receiving maintenance dialysis are not represented in the current literature.

Methods

We surveyed 223/380 (response rate 59%) hospitalized patients receiving chronic dialysis in Upstate, NY. We asked patients about their views on PAD using the following two questions: (1) Which of the following best describes your views about whether a physician should ever be allowed to take the final action in response to a patient’s request for assisted death? (2) In case you had a great degree of pain and suffering and if physician-assisted death were legally available, do you think you might request it for yourself? Response options for the first and second questions included: (a) support/yes (b) oppose/no (c) uncertain. Candidate predictors in the final logistic regression model included age, time on dialysis, race, marital status, income level, education level, spirituality, social support, symptom burden, sense of burdensomeness, fear of death, and fear of the dying process.

Results

Nearly 41% of patients were <65 years old, 47% were women, and 41% were White. Fifty-five percent supported PAD, 20% expressed uncertainty, and 22% opposed it with missing data on 3% of patients. In response to the question, if patients would choose PAD for themselves, in case of pain and suffering, and if PAD was legally available: 37% said yes, 44% no, and 17% chose the unsure option. In the bivariate analyses, those who supported PAD had lower mean spirituality, higher anxiety about the dying process, and had spent more time on dialysis compared to those who opposed or were uncertain (p<0.05) about it. In the final model, none of the candidate predictors were significant for support or opposition/uncertainty about PAD.

Conclusion

More than half of hospitalized dialysis patients supported PAD, while fewer would actually use this option in case of pain and suffering. In the absence of the legalization of PAD in the NY state, the promotion of palliative care and hospice services and high-quality end-of-life care for dialysis patients are high priority policy issues.

Funding

  • Private Foundation Support