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Attachment styles of Oregonians who request physician-assisted death

Published online by Cambridge University Press:  04 May 2011

Robert L. Oldham ,
Steven K. Dobscha ,
Elizabeth R. Goy  and
Linda Ganzini
Robert L. Oldham
Affiliation:
Health Services Research and Development, Department of Veterans Affairs, Portland, Oregon Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
Steven K. Dobscha
Affiliation:
Health Services Research and Development, Department of Veterans Affairs, Portland, Oregon Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
Elizabeth R. Goy
Affiliation:
Health Services Research and Development, Department of Veterans Affairs, Portland, Oregon Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
Linda Ganzini*
Affiliation:
Health Services Research and Development, Department of Veterans Affairs, Portland, Oregon Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
*
Address correspondence and reprint requests to: Linda Ganzini, Mental Health Division, R&D 66, Portland Veterans Affairs Medical Center, 3710 SW US Veterans Hospital Road, Portland, OR 97239-2964. E-mail: linda.ganzini@va.gov
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Abstract

Objective:

Qualitative analyses suggest that requests for physician-assisted death (PAD) may often be the culmination of a person's lifelong pattern of concern with issues such as control, autonomy, self-sufficiency, distrust of others, and avoidance of intimacy. Such characteristics may be measured by attachment style. We compared family members’ reports of attachment style in Oregonians who did and did not request PAD.

Method:

Eighty-four family members of terminally ill patients who requested PAD before death and 63 members of a comparison group that included family members of terminally ill Oregonians who died without requesting PAD rated their loved ones' attachment style in a one-time survey.

Results:

Individuals who requested PAD were most often described as having dismissive personality styles (56%) compared to 41% of comparison individuals, and on continuous measures of relational style, the highest mean score among PAD requesters was for dismissive style. There were marginally significant differences in the proportions of each attachment style when comparing the two groups (p = 0.08).

Significance of results:

Patients’ attachment styles may be an important factor in requests for PAD. Recognition of a patient's attachment style may improve the ability of the physician to maintain a constructive relationship with the patient throughout the dying process.

Keywords

Physician-assisted deathTerminally illAttachment stylesOregon Death with Dignity Act
Type
Original Articles
Information
Palliative & Supportive Care , Volume 9 , Issue 2 , June 2011 , pp. 123 - 128
Copyright
Copyright © Cambridge University Press 2011

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