physician-assisted suicide

physician-assisted suicide (PAS),

voluntary termination of one's own life by administration of a lethal substance with the direct or indirect assistance of a physician. Physician-assisted suicide is to be distinguished from the withholding or discontinuance of life-support measures in terminal or vegetative states so that the patient dies of the underlying illness, and from administration of narcotic analgesics in terminal cancer, which may indirectly hasten death.

Questions and controversies about assisted suicide have become widespread within the health care community and society at large. In 1997 the U.S. Supreme Court ruled that the Constitution neither permits nor prohibits PAS. In the same year, Oregon became the first state to legalize suicide. Under Oregon law any mentally competent resident of the state who has reached the age of 18 and who has a terminal illness that is expected to cause death within 6 months may make a voluntary and informed decision to terminate life by taking a lethal overdose of oral medicine prescribed for that purpose by a physician. The physician is immune from civil or criminal prosecution. Belgium and the Netherlands legalized PAS on similar terms in 2002. The American Medical Association and the American Nurses Association have issued official position statements opposing assisted suicide in all circumstances. Among objections voiced by opponents of the legalization of PAS and its integration into medical practice are the erosion of public trust in the health care professions; the radical change in the traditional physician-patient relationship, which has always been beneficial and constructive; the concern that if PAS were to become an accepted option for the "treatment" of certain illnesses, physicians might be required to present it to patients as an alternative and that managed-care or other third-party payers might favor it as least expensive; and the fear that, once legalized, PAS would be permitted for conditions not terminal, and that people other than the patient would eventually be empowered to make the decision. The debate over PAS has drawn attention to shortcomings in the care of the dying and to the preeminent obligation of health care professionals to provide responsible, respectful, appropriate, and ethically sound care. see also end-of-life care, advance directive.

physician-assisted suicide/euthanasia

Assisted suicide Medical ethics A passive intervention by a physician to help a person end life, including prescribing medications–eg, narcotics or barbiturates or counseling an ill Pt to use an overdose to end life; general situations in which a physician is called to assist in a final 'role call'; general concerns triggering requests for PAS&E include loss of control, dignity, being a burden on others. See Active euthanasia, Euthanasia, Initiative 119, Kevorkian, Slippery Slope.