Responding to requests for physician-assisted suicide.

Paul B. Bascom & Susan W. Tolle, Responding to Requests for Physician-Assisted Suicide, 288 JAMA 91 (2002).

Studies of dying patients have shown that about half would like the option of physician-assisted suicide (PAS) to be available for possible future use. Those percentages decrease significantly with each step patients take toward action. Studies show that although about ten percent seriously consider PAS, only 1% of dying patients specifically request it, and one in ten of those patients actually receive and take a lethal prescription. But most patients' desires for PAS diminish as their underlying concerns are identified and addressed directly To help identify concerns motivating a patient's request for PAS, physicians should talk with patients about their expectations and fears, options for end-of-life care, goals, family concerns and burdens, suffering or physical symptoms, sense of meaning and quality of life, and symptoms of depression. A patient with advanced amyotrophic lateral sclerosis (ALS) who requested PAS illustrates how a hasty response may adversely affect patient care and the health care team. Although physicians should...