To the Editor.
—Quill has written a thoughtful article on the issues that confront dying patients.1 However, as a suicidologist and a psychiatrist who has treated suicidal, terminally ill patients, I cannot agree with his statement that "some suicides may be rational" and presumably should be sanctioned. In some ways, Quill's statement is ironic, coming as it does after his excellent exploration of the hidden emotional aspects that lie behind the patient's request, "Doctor, I want to die. Will you help me?" In fact, in each of the vignettes he presents, none of the patients really wanted to commit suicide, underscoring Quill's point that physicians not take this question at face value. How then can we dispense with all the emotionality and conclude that suicide is rational if one simply understands the disease, the prognosis, and the treatment alternatives? Most of us try to make rational decisions about the
Marzuk PM. Assisted Suicide: Sheer Cliff or Clinical Reality?. JAMA. 1994;271(1):23-24. doi:10.1001/jama.1994.03510250039018