The latest issue of JAMA showcases the views of leading American doctors and lawyers on physician-assisted suicide (PAS). The theme is captured by the headline above one of the articles: “Physician-Assisted Dying: Turning Point?” After California legalised it last year, other US states could follow. Nothing novel emerges from the discussion, other than a sense of impending change.
One article by a leading advocate of PAS, Timothy Quill, of the University of Rochester argues that “Patients with serious illness wish to have control over their own bodies, their own lives, and concern about future physical and psychosocial distress. Some view potential access to physician-assisted death as the best option to address these concerns.”
Dr Quill et al also insist that the terminology must change:
“Physician-assisted ‘suicide’ connotes mental illness, and suggests a self-destructive aspect of such decisions that many find offensive. Even the term physician-assisted death, although better than physician-assisted suicide, puts more emphasis on the physicians’ role than may be warranted. This issue is driven by patients and reflects fundamental concerns of patients living with serious illnesses who feel that they are being destroyed by their illness; they are seeking what they regard as a small measure of self-preservation. The term ‘hastening death’ is less judgmental and respects the profound search for preservation of the self that many patients seek, even at the last moments of their lives.”
Dr Tony Yang, of George Mason University, and Dr Farr Curlin, of Duke University, go to more fundamental issues. They question whether doctors ought to support the desire of a few patients for unlimited autonomy.