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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: [email protected]
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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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References

REFERENCES

Ainsworth, M.S., Blehar, M.C., Waters, E., et al. (1978). Patterns of Attachment: A Psychological Study of the Strange Situation. Hillsdale, NJ: Erlbaum.Google Scholar
Ainsworth, M.S. (1979). Infant-mother attachment. American Psychologist, 34, 932–937.CrossRefGoogle ScholarPubMed
Bartholomew, K. & Horowitz, L.M. (1991). Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology, 61, 226–244.CrossRefGoogle ScholarPubMed
Bharucha, A.J., Pearlman, R.A., Back, A.L., et al. (2003). The pursuit of physician-assisted suicide: Role of psychiatric factors. Journal of Palliative Medicine, 6, 873–883.CrossRefGoogle ScholarPubMed
Bradley, J.M. & Caffery, T.P. (2001). Attachment among older adults: Current issues and directions for future research. Attachment & Human Development, 3, 200–221.CrossRefGoogle ScholarPubMed
Ciechanowski, P.S., Katon, W.J., Russo, J.E., et al. (2001). The patient-provider relationship: Attachment theory and adherence to treatment in diabetes. American Journal of Psychiatry, 158, 29–35.CrossRefGoogle ScholarPubMed
Ciechanowski, P.S., Katon, W.J., Russo, J.E., et al. (2002a). Association of attachment style to lifetime medically unexplained symptoms in patients with hepatitis C. Psychosomatics, 43, 206–212.CrossRefGoogle ScholarPubMed
Ciechanowski, P.S., Walker, E.A., Katon, W.J., et al. (2002b). Attachment theory: A model for health care utilization and somatization. Psychosomatic Medicine, 64, 660–667.Google Scholar
Ciechanowski, P.S., Russo, JE., Katon, W.J., et al. (2006). Where is the patient? The association of psychosocial factors and missed primary care appointments in patients with diabetes. General Hospital Psychiatry, 28, 9–17.CrossRefGoogle ScholarPubMed
Dozier, M. (1990). Attachment organization and treatment for adults with serious pychopathological disorders. Development and Psychopathology, 2, 47–60.CrossRefGoogle Scholar
Feeney, J.A. & Ryan, S.M. (1994). Attachment style and affect regulation: Relationships with health behavior and family experiences of illness in a student sample. Health Psychology, 13, 334–345.CrossRefGoogle Scholar
Ganzini, L., Dobscha, S.K., Heintz, R.T., et al. (2003). Oregon physicians’ perceptions of patients who request assisted suicide and their families. Journal of Palliative Medicine, 6, 381–390.CrossRefGoogle ScholarPubMed
Ganzini, L., Goy, E.R. & Dobscha, S.K. (2007). Why Oregon patients request assisted death: Family members’ views. Journal of General Internal Medicine, 23, 154–157.CrossRefGoogle ScholarPubMed
Ganzini, L., Goy, E.R., & Dobscha, S.K. (2008). Prevalence of depression and anxiety in patients requesting physicians' aid in dying: Cross sectional survey. British Medical Journal, 337, 1682.CrossRefGoogle ScholarPubMed
Ganzini, L., Goy, E.R. & Dobscha, S.K. (2009). Oregonians' reasons for requesting physician aid in dying. Archives of Internal Medicine, 169, 489–492.CrossRefGoogle ScholarPubMed
Ganzini, L., Silveira, M.J. & Johnston, W.S. (2002). Predictors and correlates of interest in assisted suicide in the final month of life among ALS patients in Oregon and Washington. Journal of Pain and Symptom Management, 24, 312–317.CrossRefGoogle Scholar
Hazan, C. & Shaver, P. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52, 511–524.CrossRefGoogle ScholarPubMed
Maunder, R.G., Panzer, A., Viljoen, M., et al. (2006). Physicians’ difficulty with emergency department patients is related to patients’ attachment style. Social Science & Medicine, 63, 552–562.CrossRefGoogle ScholarPubMed
Wineberg, H. & Werth, J.L. (2003). Physician-assisted suicide in Oregon: What are the key factors? Death Studies, 27, 501–518.CrossRefGoogle ScholarPubMed