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March 10, 1999

Oncologists' Practice of Euthanasia and Physician-Assisted Suicide—Reply

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(10):897-899. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-10-jac90000

In Reply: As Dr Spudis argues there are differences between foreseeing a risk of death and intending death. Intending death is having death as the goal and primary motivating factor. Conversely, foreseeing some risk of death occurs in most medical interventions, from prescribing antibiotics to performing cardiac surgery. Yet no one considers these euthanasia or PAS. Injecting patients with muscle relaxants or phenobarbital without respiratory support or injecting patients with large doses of potassium chloride occurs only when the actor intends—and not merely foresees—the patient's death. We did not use the terms euthanasia or physician-assisted suicide in our survey but provided descriptive phrases that were thoroughly pretested and have been used in other rigorous surveys. Nevertheless, as we reported, 12.5% of physicians misclassify cases of withholding medical treatments or increasing morphine for pain control as euthanasia or PAS, and an additional 18.4% of physicians misclassify euthanasia as PAS.