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January 19, 2016

Responding to Patients Requesting Physician-Assisted Death: Physician Involvement at the Very End of Life

Author Affiliations
  • 1Palliative Care Division, Department of Medicine, University of Rochester Medical Center, Rochester, New York
  • 2Harborview Medical Center, University of Washington
  • 3Fred Hutchinson Cancer Research Center, Seattle, Washington
  • 4Cambia Palliative Care Center of Excellence, University of Washington, Seattle
  • 5Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
  • 6Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
  • 7Ariadne Labs, Brigham and Women’s Hospital, Harvard School of Public Health, Boston, Massachusetts
JAMA. 2016;315(3):245-246. doi:10.1001/jama.2015.16210

Is physician-assisted death ever justifiable?—Yes.

Both the lived experience of a person with a serious illness as well as commonly recognized ethical principles provide guidance in answering this question. A woman in her 40s faced her ovarian cancer with great courage, sought available new oncologic treatments, and carefully researched how to relieve potential end-of-life pain, dyspnea, nausea, and other physical or psychosocial distress should it occur as she became sicker. She considered the possibility of physician-assisted death and received a prescription from her physician in Washington because it gave her “a way out” if her existence became intolerable. She was not certain she would use the medication, and she made sure her family supported her plan. In the end, with help from hospice, family, and clinicians, she felt the last part of her life was “surprisingly okay,” and she died comfortably, in her home, the medications potentially intended to hasten death unused.

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