Contact:
Lisa Jacobs
Michael Fagan
212/880-5300
Annual Meeting News Room:
303/446-4472
AMERICAN SOCIETY OF CLINICAL ONCOLOGY Thirty-third Annual Meeting May 17 - 20, 1997
FACTS ON END-OF-LIFE ISSUES IN THE UNITED STATES
Mortality and Site of Death
2.4 million people annually die in the United States. Of these:
∑ 61% die in hospitals
∑ 17% die in nursing homes
∑ 22% die at home, including 400,000 in hospice care
∑ 560,000 die of cancer
Planning for End-of-Life Care
SUPPORT, a survey of 10,000 terminally ill patients sponsored by the Robert Wood Johnson Foundation, published in 1994, found that:
∑ Nearly 1/2 of do-not-resuscitate orders were written within one to two days before death, suggesting lack of advance planning in terminal illness
∑ Nearly 1/3 of patients preferred to forego resuscitation, yet their doctors knew about this preference in only 1/3 of the cases
∑ 1/2 of patients able to communicate in the last three days of life said they were in severe pain
Financial and Legal Issues
∑ 1/3 of Medicare payments go to people in their final year of life
∑ Over 1/4 of all hospital costs in the U.S. go to caring for patients -- many of them terminally ill -- in the nationÃs 78,000 intensive-care beds
∑ The average savings derived from not resuscitating a dying patient whose heart had stopped is almost $14,000
∑ Nearly 1/3 of terminally ill patients used most or all of their savings to cover uninsured medical expenses like homecare (SUPPORT survey)
∑ 1/3 of terminally ill patients require substantial caregiving assistance from a family member, who often must quit work or take time off to provide the needed care (SUPPORT survey)
∑ In 1 of 10 families, the stress of dealing with a terminally ill relative led to serious health problems in other family members (SUPPORT survey)
Physician-Assisted Suicide
∑ Surveys of the general public and physicians in Michigan and Oregon suggest that roughly two-thirds of Americans support the legalization of physician-assisted suicide, as do more than half of doctors.
∑ A recent Canadian survey suggests that the general population is relatively evenly split on the legalization of physician-assisted suicide. The 1995 survey of 1,240 members of the general public, 146 physicians and 33 oncologists in Canada found that:
-- 52% of the general population believe ìa doctor should be allowed by law to prescribe medication to a terminally ill cancer patient so that the patient can commit suicide.î 22% of general practitioners and 24% of oncologists agreed with the statement.
-- 67% of the general population surveyed stated that if they had terminal cancer, they would like to be allowed by law to end their own lives with the help of a doctor. Only 35% of general practitioners and 39% of oncologists expressed the same desire.
-- 65% of patients with terminal cancer surveyed said that if a terminally ill cancer patient requests it, a doctor should be allowed by law to administer medications to cause death. Only 27% of general practitioners, and 27% of oncologists agreed with the statement.
∑ A separate 1994 survey of physicians conducted by researchers at the Dana Farber Cancer Institute found that 48% of oncologists could imagine a circumstance under which they might consider euthanasia or assisted suicide for themselves.
[Both the Canadian and Dana Farber studies were published in the February, 1997 issue of The Journal of Clinical Oncology.]
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