Care of the Hopelessly Ill: Proposed Clinical Criteria for Physician-Assisted Suicide
Quill, Timothy E.
Cassel, Christine K.
Meier, Diane E.
New England Journal of Medicine. 1992 Nov 5; 327(19): 1380-1384.
Our purpose is to propose clinical criteria that would allow physicians to respond to requests for assisted suicide from their competent, incurably ill patients. We support the legalization of such suicide, but not of active euthanasia. We believe this position permits the best balance between a humane response to the requests of patients...and the need to protect other vulnerable people. We strongly advocate intensive, unrestrained care intended to provide comfort for all incurably ill persons. When properly applied, such comfort care should result in a tolerable death, with symptoms relatively well controlled, for most patients. Physician-assisted suicide should never be contemplated as a substitute for comprehensive comfort care or for working with patients to resolve the physical, personal, and social challenges posed by the process of dying. Yet it is not idiosyncratic, selfish, or indicative of a psychiatric disorder for people with an incurable illness to want some control over how they die. The idea of a noble, dignified death, with a meaning that is deeply personal and unique, is exalted in great literature, poetry, art, and music. When an incurably ill patient asks for help in achieving such a death, we believe physicians have an obligation to explore the request fully and, under specified circumstances, carefully to consider making an exception to the prohibition against assisting with a suicide.
Active Euthanasia; Allowing to Die; Assisted Suicide; Attitudes; Chronically Ill; Competence; Consent Forms; Consent; Consultation; Death; Diagnosis; Drugs; Euthanasia; Family Members; Forms; Guidelines; Illness; Literature; Patients; Physician Patient Relationship; Physician's Role; Physicians; Prognosis; Public Opinion; Public Policy; Referral and Consultation; Suffering; Suicide; Terminal Care; Terminally Ill;
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