Document 0973
 DOCN  M94A0973
 TI    Intentionally hastened death in AIDS--role of caregiving partners.
 DT    9412
 AU    Cooke M; Gourlay L; Collette L; Boccellari A; Chesney M; Folkman S;
       Center for AIDS Prevention Studies, University of California, San;
       Francisco.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):238 (abstract no. PB0966). Unique
       Identifier : AIDSLINE ICA10/94371602
 AB    OBJECTIVES: To determine the extent to which gay men dying of AIDS
       receive increases in medications intended to hasten death and to assess
       whether mood measures, relationship characteristics or caregiving burden
       prior to the death of the partner with AIDS (PWA) differ between
       caregiving partners (CG's) who administer medications to hasten death
       and those who use medications solely for symptom control. METHOD: Data
       are from a prospective study of the caregiving partners in longstanding
       relationships (mean > 6 years) with gay men ill with AIDS. Predictor
       variables measured at study entry were: CG HIV status, mood, perceived
       caregiving burden, PWA diagnoses, site of death, instrumental needs of
       PWA, and characteristics of the CG-PWA relationship. In an interview 8
       weeks after the PWA's death, CG's were asked if they had increased their
       partner's narcotic and/or sedative dose, whether the goal was to control
       symptoms, hasten death or both, and whether the CG was comfortable with
       the decision. RESULTS: Of 136 PWA's who died of AIDS, 66 (48%) received
       a medication increase immediately prior to death; 17 (26%) of these
       increases were intended to hasten death. The instrumental needs of these
       PWA's were not statistically different from those of PWA's who received
       medication only to control symptoms (p = 0.55). No significant
       differences were seen between CG's who increased medication to hasten
       death and those using medication for symptom control in HIV positivity
       (35% + vs. 34% +, p = 0.93), depression, anxiety, anger, caregiving
       burden or relationship characteristics. CG's who administered a
       medication increase to hasten death perceived caregiving more positively
       at baseline (p = 0.01). Of the 17 CG's who reported medication increases
       intended to hasten death, 12 discussed the increase with the MD. Eight
       weeks after the PWA's death, 48% of the CG's were completely comfortable
       with the decision to increase medication; there was no significant
       difference between CG's who had intended to hasten death and those who
       had increased medication to control symptoms. CONCLUSION: The decision
       to hasten death was not associated with negative CG mood, poor
       relationship quality or caregiving burden and did not cause excessive
       discomfort eight weeks after the PWA's death. Discussion of assisted
       suicide has focused on physicians; attention should be given to the role
       of CG's.
 DE    Acquired Immunodeficiency Syndrome/*NURSING  Caregivers/*PSYCHOLOGY
       *Homosexuality  Human  Male  Narcotics/ADMINISTRATION & DOSAGE
       Prospective Studies  Role  *Suicide, Assisted  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).