RT Journal A1 Rieger D T1 REsponding to patient requests for physician-assisted suicide JF JAMA JO JAMA YR 1999 FD January 20 VO 281 IS 3 SP 227 OP 229 DO 10-1001/pubs.JAMA-ISSN-0098-7484-281-3-jbk0120 UL http://dx.doi.org/10-1001/pubs.JAMA-ISSN-0098-7484-281-3-jbk0120 AB To the Editor: Although I appreciated Dr Emanuel's1 enumeration of principles to be used in assessing patient requests and physician responses, her article seemed to emphasize and weight one or another of the principles to arrive at a predetermined result. To avoid "unwanted intervention" a patient may be permitted to starve to death, but "relief of suffering," including psychological suffering, is prohibited because of a predetermined decision that PAS is wrong? I think not. The principles enumerated could just as easily have been used to justify PAS. While I generally agree with the process and results included in Emanuel's article, in no way does her reasoning reflect an objective approach and response to a very complicated and difficult problem.