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—Dr Grisolia's proposal to legalize physician-assisted suicide in a couple of test states will probably occur as a result of referendum, possibly as early as this fall. The larger infrastructure of suicide specialists, whom he euphemistically calls terminal care specialists, would be costly and a poor career choice until there was strong social approval and reimbursement for assisted suicide.The institutionalization of specialists in physician-assisted suicide that Grisolia proposes is another form of the "all or nothing" we both lament and the overspecialization that has fragmented and encumbered primary patient care. A middle ground may lie in fundamentally restructuring primary care systems for the common event of end-of-life care. We could assure universal access to hospice benefits to give patients a choice. We could minimize legal controls on narcotics for terminally ill persons to improve pain control, promote autonomy, decrease fear of loss of control, and empower nonmedical
Miles S. Physicians and Their Patients' Suicides-Reply. JAMA. 1994;272(18):1410. doi:10.1001/jama.1994.03520180034029
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