Need for Control Drives Assisted Suicide Requests : Patients who went through with assisted suicide wanted to be self-reliant until the end, studies show.

Another concern that arose before the passage of the Death with Dignity Act was that the act might undermine efforts to improve hospice or palliative care. Instead, 86% of assisted suicides occurred in hospice patients, Dr. Ganzini said.

Opposition to the law remains fairly strong. About 42% of hospice chaplains and a third of hospice nurses oppose the law, she said. Yet few said they would actively oppose it with a patient, and no chaplain would seek transfer of a patient who requested assisted suicide.

“Even though they oppose suicide, their moral feelings about abandoning the patient are stronger,” she said, adding that the chaplains said providing nonjudgmental support was the most effective way to help change a person's mind.

The Oregon experience highlights “a very rarified group” of people whose needs are not generalizable but should not be ignored, Dr. Ganzini concluded. As an example, she cited Annie, who stopped hospice services after 13 days, saying, “They [the staff] are really nice, but I just hate it when other people tell me what to do.”

The one-size-fits-all hospice care model actually does not fit everyone, Dr. Ganzini said. “I think hospice and palliative care have to change to individualize the treatment they offer.”

'Some people want to leave this world in the driver's seat. That's their major goal.' DR. GANZINI