Emergency physicians and physician-assisted suicide, Part II: emergency care for patients who have attempted physician-assisted suicide.
Part I of this article reviewed key terms, events, and arguments in the heated national debate regarding physician-assisted suicide (PAS). Part II of the article examines the role of emergency physicians in caring for patients who present to the emergency department after an incomplete or unsuccessful attempt at PAS. The article considers the analogous cases of emergency care for other patients who have attempted suicide and care for terminally ill patients who refuse life-sustaining treatment. Morally relevant features of these situations are identified, including the decisionmaking capacity and the choices of the patient, the opinions of the patient's family or other surrogate decisionmakers, the presenting condition and medical history of the patient, the nature of the patient's suicide attempt, and the physician's own moral convictions. The article evaluates the 3 management options: aggressive intervention to preserve life, palliative care only, and assistance in completing the suicide. It concludes with several general recommendations for addressing these situations.
Moskop
J C
JC
Department of Medical Humanities, Brody School of Medicine, East Carolina University, Greenville, NC 27858, USA. moskopj@mail.ecu.edu
Iserson
K V
KV
D004635:Emergency Medicine / Q000331:legislation & jurisprudence*; D004992:Ethics, Medical; D006801:Humans; D008020:Life Support Care / Q000331:legislation & jurisprudence; D028681:Moral Obligations; D010166:Palliative Care; D010819:Physician's Role; D017236:Suicide, Assisted / Q000331:legislation & jurisprudence*; D013406:Suicide, Attempted / Q000331:legislation & jurisprudence*; D013727:Terminal Care / Q000331:legislation & jurisprudence; D016312:Treatment Refusal / Q000331:legislation & jurisprudence; D014481:United States