Bernat, in the accompanying article, has nicely summarized important arguments both favoring and opposing physician-assisted suicide (PAS). In the public arena, the debate might appear at first to be one of extremes. On one side are those demanding a total ban on PAS. On the other are those who claim that PAS is a constitutional right and should remain unregulated, as a private transaction between patient and physician.
Within medical circles, however, the conceptual distance separating the disputants ought to be much narrower. Colleagues and I have argued that no physician can advocate, with integrity, anything resembling "PAS on demand." The alternative to an outright ban on PAS is PAS only as a last resort for a small group of carefully selected patients.1-3
Bernat further focuses attention on one of the most critical elements in the debate—the impact of PAS policy on palliative care. He argues, as have many