Margaret A.Winker, MDIndividualAuthorPhil B.FontanarosaMD, Senior EditorsIndividualAuthor
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
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
Emanuel L. Responding to Patient Requests for Physician-Assisted Suicide—Reply. JAMA. 1999;281(3):227-229. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-3-jbk0120