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January 20, 1999

Responding to Patient Requests for Physician-Assisted Suicide—Reply

Author Affiliations

Margaret A.Winker, MDIndividualAuthorPhil B.FontanarosaMD, Senior EditorsIndividualAuthor

JAMA. 1999;281(3):227-229. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-3-jbk0120

In Reply: I appreciate the opportunity to further explain aspects of the protocol that I proposed for clinicians responding to a request for PAS. The algorithm is a method for organizing thinking rather than a step-by-step recipe. As with most algorithms, clinicians must tailor it to the individual patient.

While some believe that PAS can be legitimate, others do not. Physicians are not obliged to agree with a patient who requests it. Rather, physicians need to appreciate and acknowledge the patient's experience. This difference becomes stark when by agreeing with the patient, the physician is perceived by the patient as not valuing the patient's life. The patient's perceived worthlessness and burdensomeness feel confirmed, and the patient is propelled toward suicide.14

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