Facing requests for physician-assisted suicide: toward a practical and principled clinical skill set.
Requests for physician-assisted suicide are not a new phenomenon, and many physicians are likely to face this challenging situation. This article proposes for professionals an 8-step approach to respond to requests for physician-assisted suicide. The approach seeks to identify and treat the root causes of the request and aims to present a plan for consistent application of a set of clinical skills. Justification for the steps requires only 2 noncontentious principles: the patient should be free of unwanted intervention, and the physician is obligated to provide suffering patients with comfort care. Care based on these 2 principles alone does not include physician-assisted suicide. The approach does, however, justify patient refusal of oral intake in specific circumstances. The approach could resolve a majority of requests for physician-assisted suicide and should be tested further for clinical efficacy.
Emanuel
L L
LL
Institute for Ethics, American Medical Association, Chicago, IL 60610, USA.
D032722:Advance Care Planning; D002983:Clinical Competence; D003663:Decision Trees; D004992:Ethics, Medical; D006801:Humans; D028681:Moral Obligations; D026684:Personal Autonomy; D013315:Stress, Psychological; D017236:Suicide, Assisted; D028761:Withholding Treatment