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March 2, 1990

Physician Participation in Assisted Suicide

JAMA. 1990;263(9):1198. doi:10.1001/jama.1990.03440090027011

To the Editor.—  David Rivlin won his court case and told reporters: "I'm surprised, I'm not scared. I feel rather peaceful. There's a little bit of fear—the fear of the unknown—but not much" (USA Today. July 21, 1989). Fifteen days later he was dead. The legal decision allowed him to determine the time, place, and manner of his death—sedation followed by termination of the respirator. David was competent, not in a persistent vegetative state, nor was he an advanced case of cardiac failure or dependent on advanced life support. He was not terminally ill and imminently dying. He was quadriplegic and respirator dependent and argued: "I can't see living like this for 20 more years. It could turn a person bitter toward life and toward people, and I don't want that to happen to me" (USA Today. July 7,1989). He said he was tired of being a burden on others