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March 2, 1990

Physician Participation in Assisted Suicide-Reply

JAMA. 1990;263(9):1198. doi:10.1001/jama.1990.03440090027010

In Reply.—  Dr Abrams correctly observes that, when there is a conflict between the physician's duty to provide life-sustaining medical care and the physician's duty to relieve suffering, the preferences of the patient must prevail.1 However, it is not "clear" that therefore physicians must be available to assist a patient's suicide. The right of a patient to refuse treatments that are unwelcome is very different from a right to demand the physician's participation in the patient's suicide. Indeed, while we ordinarily let the patient choose whether to accept a physician's recommendations for treatment, we do not permit the patient to decide what recommendations will be made.I agree that the concern about burdening family and friends is not "unquestionably irrational." But there is a real concern that for some patients the right to die might become a duty to die. There is no shortage of people who question whether we