From the Institute for Ethics, American Medical Association, Chicago, Ill.
Health Law and Ethics section editors: Lawrence O. Gostin, JD, the
Georgetown/Johns Hopkins University Program on Law and Public Health, Washington,
DC, and Baltimore, Md; Helene M. Cole, MD, Contributing Editor, JAMA.
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.
Emanuel LL. Facing Requests for Physician-Assisted SuicideToward a Practical and Principled Clinical Skill Set. JAMA. 1998;280(7):643-647. doi:10.1001/jama.280.7.643