Euthanasia Easier on Loved Ones, Study Says

Having time to prepare and say goodbye may ease the grief

(HealthDay is the new name for HealthScoutNews.)

THURSDAY, July 24, 2003 (HealthDayNews) -- If someone you loved was dying from cancer, do you think it would be easier for you if your loved one chose to die by euthanasia or passed away from natural causes?

Dutch researchers looked at just that question, and the answers they found may surprise you.

The study, which appears in the July 26 issue of the British Medical Journal, says death by euthanasia may cause less grief for family and friends than a natural death does.

The researchers suspect there are several reasons friends and family of people who died by euthanasia had fewer symptoms of grief. One is that they had time to prepare and talk about the death. Another is that they had the chance to say goodbye to their loved one, according to the study.

Euthanasia, which is illegal just about everywhere, is legal in the Netherlands, where about 3,200 people choose to die by that method every year. About 80 percent of those people have terminal cancer.

For the study, researchers from the University Medical Center Utrecht asked friends and relatives of cancer patients who had died either by euthanasia or of natural causes between 1992 and 1999 to participate. One hundred and eighty-nine relatives and friends of 58 people who had died by euthanasia agreed to participate, while 316 loved ones of 114 people who had died naturally from their cancer volunteered.

Sometime between January 2000 and August 2003, all of the bereaved family members and friends completed a questionnaire that contained seven different psychological assessments of grief, post-traumatic stress, general well-being, depression and personality. The volunteers were also asked about specific aspects of their loved one's death.

The researchers found the friends and relatives of people who had died by euthanasia had fewer symptoms of severe grief or post-traumatic stress symptoms, and fewer current symptoms of grief.

Nearly 6 percent of friends and family of those who died of natural causes were suffering from traumatic grief syndrome, while just over 2 percent of loved ones who had died by euthanasia were. Traumatic grief refers to symptoms that vary dramatically from what is considered normal, says the study.

The researchers point out that there were differences in the groups, which could influence the results. For example, the friends and family members of the euthanasia patients had a higher level of education on average and were less religious. The euthanasia group also contained more cousins, in-laws and friends. The group whose loved ones died of natural causes contained more children and siblings.

Dr. Jay Brooks, chief of hematology and oncology at Ochsner Clinic Foundation Hospital in New Orleans, says the differences in people's backgrounds could make a big difference in the study's results.

"This kind of work is hard because there are so many variables in a patient's and family's background and their perception of death," Brooks explains.

In the study, the researchers say their results aren't meant to advocate the use of euthanasia, rather the study points out the need for the same types of counseling and care for all terminally ill patients.

Brooks agrees adding that open discussion of death is sorely lacking in the United States. "As a country, we don't die well," he says.

He says hospice services are underutilized and many people think they're available only to help the dying patients. But, he says, "hospice not only helps the person dying, but it helps the family prepare for the inevitable separation."

This issue of the British Medical Journal contains several articles about euthanasia and other end-of-life issues. Another study finds that doctors tend to overestimate the survival of terminally ill cancer patients, while still another says that doctors are deeply affected by the deaths of their patients.

More information

To learn more about coping with loss, visit the Hospice Foundation of America. For more information on euthanasia, go to the American Academy of Family Physicians.

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