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Health Law and Ethics |

Facing Requests for Physician-Assisted Suicide:  Toward a Practical and Principled Clinical Skill Set

Linda L. Emanuel, MD, PhD
JAMA. 1998;280(7):643-647. doi:10.1001/jama.280.7.643.
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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.

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Approach to the patient who requests physician-assisted suicide (PAS).

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