A telling, useful study.

Byline: The Register-Guard

While it won't - can't - be the final word on the subject, a new study of hospice workers on why terminally ill patients choose to end their lives under Oregon's Death With Dignity Act should put some notions about the act to rest. For that reason alone, the study is timely and welcome.

Conducted by Dr. Linda Ganzini, a psychiatry professor at Oregon Health and Science University and director of the palliative care treatment program at the Portland Veterans Affairs Medical Center, the survey - the results of which were published Thursday in the New England Journal of Medicine - of 306 nurses and 91 social workers who treat hospice patients showed that, by far, patients who request physician-assisted suicide do so not because they are depressed or lack social support, but because they want control over their death.

In fact, depression, constant nausea and lack of social support ranked Nos. 19, 20 and 21 in a list of 21 reasons why those who used physician-assisted suicide chose to do so. Ranking Nos. 1, 2 and 3 were a desire to control the circumstances of one's death, a readiness for death and a desire to die at home.

In between the top three and the bottom three were, in order, such reasons as viewing continued existence as pointless, loss of or fear of losing independence, poor quality of life, loss of or fear of losing dignity, pain or a fear of worsening pain, inability to care for oneself, perceiving oneself as a burden to others, inability to engage in pleasurable activities, seeing life's tasks as complete, fatigue or fear of worsening fatigue, dyspnea (shortness of breath), loss of or fear of losing bowel and bladder functions, confusion, experience witnessing bad deaths and seeing oneself as or fear of becoming a financial drain on others.

The survey of hospice workers is important because nearly all of the physician-assisted suicides in Oregon - 71 of 91 cases in the past four years - involved patients who received hospice care. The survey questionnaire was mailed to 545 hospice nurses and social workers at all 50 Medicare-certified hospices in Oregon. A total of 397 individuals responded. Of those who did respond, 59 percent said they supported Oregon's physician-assisted suicide law, while 26 percent opposed it and 14 percent said they were neutral.

The encouraging thing about the hospice study is that it reinforces the commonly held feeling that the Oregon law is working as intended, is not being abused and is giving the terminally ill who desire it the end-of-life control they seek.