Demandes d'euthanasie: quelle réalité dans un centre anticancéreux

Abstract

Euthanasia is a controversial issue in today's society. In countries where euthanasia is legal, it is mainly associated with people with cancer. We retrospectively studied the frequency and basis of patients' requests for active euthanasia in the oncology setting.MethodsRecurrent requests for euthanasia made by the patients of Leon-Berard cancer center (Lyon, France) between 2001 and 2003 were recorded by questioning the physicians and nurse supervisors in charge or by collecting information from the minutes of multidisciplinary palliative care meetings. We also collected information on the general health status of the patients, their motives and their evolution over time, as well as responses from caregivers.ResultsWe identified 16 requests for euthanasia. These involved 8 men, 7 women and 1 child (median age, 56 years), corresponding to 1% of the total deaths recorded during the period. In 2 cases, the request had come from the family only. The most frequent motives were psychological distress (38%), desire for self-autonomy (31%) and pain (31%). Half of the patients, particularly those striving for autonomy, persisted with their request until death, whereas 2 of 3 requests motivated by physical or psychological distress were not maintained. Sedation was administered to 3 patients in response to recurrent requests.ConclusionRequests for euthanasia in cancer patients are rare but may occur. Sometimes suffering is not relieved by palliative care and the request is maintained. Dealing with these patients puts caregivers in a difficult situation.