title: The problem of inadequately relieved suffering.
abstract: A request for euthanasia or assistance in suicide usually derives from severe patient distress and indicates significant suffering. Although the Hippocratic purview of medicine requires that suffering be acknowledged, its causes be identified, and that steps be taken to provide adequate relief, an appreciation of the diversity of factors that may contribute to suffering underscores the need for methodical assessment and familiarity with a range of therapeutic strategies. It may be argued that when other options to effectively relieve suffering are available, euthanasia and assisted suicide fall outside of the purview of Hippocratic medicine. Given the existence of other options, the capacity for human maleficence, and the lack of resources currently allocated to the relief of suffering, this paper presents a number of reservations regarding the legalization of euthanasia and assisted suicide. In addition, it is suggested that the current community focus on the issue of inadequately relieved suffering should be harnessed to work toward the provision of care that would diminish the impression that elective death is necessary to ensure adequate relief.
authors.affiliation: Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: N I
authors.initials: NI
authors.lastname: Cherny
mesh_terms: D017028:Caregivers / Q000523:psychology; D003068:Coercion; D003657:Decision Making; D003863:Depression / Q000523:psychology / Q000628:therapy; D034723:Double Effect Principle; D004645:Empathy; D033101:Euthanasia, Active, Voluntary / Q000941:ethics*; D005190:Family / Q000523:psychology; D006701:Home Nursing / Q000523:psychology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D009369:Neoplasms / Q000523:psychology / Q000628:therapy; D059408:Pain Management; D010166:Palliative Care / Q000941:ethics* / Q000523:psychology*; D010348:Patient Care Team; D011368:Professional-Family Relations; D011640:Public Policy; D011788:Quality of Life; D012297:Right to Die / Q000941:ethics; D013315:Stress, Psychological / Q000523:psychology* / Q000628:therapy*; D017236:Suicide, Assisted / Q000941:ethics*; D013727:Terminal Care / Q000941:ethics* / Q000523:psychology; D019452:Terminally Ill / Q000523:psychology*
chemical_list: D006993:Hypnotics and Sedatives