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January 5, 1994

Assisted Suicide: Sheer Cliff or Clinical Reality?-Reply

JAMA. 1994;271(1):24. doi:10.1001/jama.1994.03510250039019

In Reply.  —Dr Holt speaks for the many compassionate mainstream physicians who skillfully use palliative care and privately struggle with the agonizing dilemmas still faced sometimes by dying patients and their families. Such physicians often express frustration about the reprimands and abstract, overly simplified solutions espoused by ethicists who seem to ignore the clinical realities that they face.1 We need to create an open environment that encourages physician compassion and creativity and provides physicians with consultation and support rather than simple proscriptions. The voice of these physicians has been largely missing from the debate about physician-assisted suicide.Dr King reminds us that assisted death should never be a substitution for good palliative care. The criteria proposed by Drs Cassel, Meier, and me attempt to ensure that hospice care has been fully utilized, depression has been treated, and patient judgment is clear and unwavering.2 Assisted death is not an