We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Responding to Patient Requests for Physician-Assisted Suicide

Linda Ganzini, MD; Mark Sullivan, MD, PhD
JAMA. 1999;281(3):227-229. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-3-jbk0120.
Text Size: A A A
Published online


To the Editor: As consultation psychiatrists we are disturbed by Dr Emanuel's1 8-step approach to dying patients who persistently request assisted suicide. The approach is burdensome, and some steps offer no benefit to the patient. Emanuel states that decision-making capacity should be assessed first to determine if the request is valid. We know of no circumstance in medicine in which it is recommended that informed consent be obtained for a procedure that will, under no conditions, be offered. Evaluating whether the patient has depression is important because the patient may have an illness for which successful treatment may improve his or her final days. However, Emanuel states that depression should be evaluated to determine whether the request is rational. Again, if assisted suicide is not an option, why take up the patient's time in making this distinction? Moreover, Emanuel assumes that the presence of depression, by itself, makes the request for assisted suicide irrational and therefore makes the patient incompetent. In fact, available data indicate a weak and variable effect of depression on end-of-life decisions, including assisted suicide.2,3


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.