Care of the Hopelessly Ill

Abstract

Our purpose is to propose clinical criteria that would allow\nphysicians to respond to requests for assisted suicide from their competent,\nincurably ill patients. We support the legalization of such suicide, but not\nof active euthanasia. We believe this position permits the best balance\nbetween a humane response to the requests of patients...and the need to\nprotect other vulnerable people. We strongly advocate intensive, unrestrained\ncare intended to provide comfort for all incurably ill persons. When properly\napplied, such comfort care should result in a tolerable death, with symptoms\nrelatively well controlled, for most patients. Physician-assisted suicide\nshould never be contemplated as a substitute for comprehensive comfort care or\nfor working with patients to resolve the physical, personal, and social\nchallenges posed by the process of dying. Yet it is not idiosyncratic,\nselfish, or indicative of a psychiatric disorder for people with an incurable\nillness to want some control over how they die. The idea of a noble, dignified\ndeath, with a meaning that is deeply personal and unique, is exalted in great\nliterature, poetry, art, and music. When an incurably ill patient asks for\nhelp in achieving such a death, we believe physicians have an obligation to\nexplore the request fully and, under specified circumstances, carefully to\nconsider making an exception to the prohibition against assisting with a\nsuicide.