Survey shows heightened focus on pain at death
■ Stretched resources and higher expectations may explain the responses.
By Andis Robeznieks — Posted Aug. 23, 2004
By focusing attention on end-of-life care, researchers say the debate over Oregon's Death With Dignity Act, which has allowed 171 assisted suicides since 1998, may have changed the way the state's residents view the death of a family member.
According to a study performed by Oregon Health & Science University researchers and published recently in the Journal of Palliative Medicine, 48% of 1,384 people surveyed between 2000 and 2002 reported having a family member die in severe to moderate pain or distress. This compares with 30.8% of the 340 people surveyed in 1996-97 who gave that response.
"The debate may have created an expectation that family members shouldn't have pain and distress as they are dying," said study author Erik K. Fromme, MD, director of palliative care research at the OHSU School of Medicine in Portland.
He explained that the study didn't necessarily measure the quality of end-of-life care as much as it measured family members' perception of patients' comfort during the last weeks of their lives.
"Presumably, illnesses haven't become more painful," he said. "Hopefully, the amount of pain hasn't increased or care hasn't gotten worse."
He also noted that resources are being stretched as more people are enrolling in hospice services while the mean number of nursing visits per patient decreased from 16 to 12.7 between the two periods studied.