Facing Requests for Physician-Assisted Suicide
Emanuel, Linda L.
JAMA. 1998 Aug 19; 280(7): 643-647.
Requests for physician-assisted suicide are not a new phenomenon, and many physicians are likely to face this challenging situation. This article proposes for professionals an 8-step approach to respond to requests for physician-assisted suicide. The approach seeks to identify and treat the root causes of the request and aims to present a plan for consistent application of a set of clinical skills. Justification for the steps requires only 2 noncontentious principles: the patient should be free of unwanted intervention, and the physician is obligated to provide suffering patients with comfort care. Care based on these 2 principles alone does not include physician-assisted suicide. The approach does, however, justify patient refusal of oral intake in specific circumstances. The approach could resolve a majority of requests for physician-assisted suicide and should be tested further for clinical efficacy.
Advance Care Planning; Artificial Feeding; Assisted Suicide; Autonomy; Communication; Competence; Conscience; Consultation; Decision Analysis; Depressive Disorder; Drugs; Family Members; Food; Freedom; Guidelines; Hospices; Moral Obligations; Palliative Care; Patients; Physicians; Practice Guidelines; Professional Competence; Referral and Consultation; Sedatives; Suffering; Suicide; Terminal Care; Treatment Refusal;
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