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Medicine and Public Policy |

The Role of Guidelines in the Practice of Physician-Assisted Suicide

Arthur L. Caplan, PhD; Lois Snyder, JD; Kathy Faber-Langendoen, MD, University of Pennsylvania Center for Bioethics Assisted Suicide Consensus Panel
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From the University of Pennsylvania Center for Bioethics, Philadelphia, Pennsylvania; and SUNY Health Science Center, Syracuse, New York.

This paper was developed by the Assisted Suicide Consensus Panel as part of the Finding Common Ground Project of the University of Pennsylvania Center for Bioethics. The paper was authored on behalf of the Panel by Arthur L. Caplan, PhD; Lois Snyder, JD; and Kathy Faber-Langendoen, MD. Members of the Assisted Suicide Consensus Panel were: Arthur Caplan, PhD (Chair); David A. Asch, MD, MBA; Rev. Ralph Ciampa; Kathy Faber-Langendoen, MD; Joseph J. Fins, MD; John Hansen-Flaschen, MD; Barbara Coombs Lee, FNP, JD; Franklin G. Miller, PhD; Sally J. Nunn, RN; David Orentlicher, MD, JD; Timothy E. Quill, MD; Elliott Rosen, EdD; James A. Tulsky, MD, and Lois Snyder, JD (Project Director). Primary clinical staff to the Panel was Jason Karlawish, MD. Additional staffing was provided by Jennifer Klocinski.

Grant Support: The Walter and Elise Haas Fund and the Wallace Alexander Gerbode Foundation supported the development of this paper and the Finding Common Ground Project on Assisted Suicide.

Requests for Single Reprints: Lois Snyder, JD, Center for Bioethics, University of Pennsylvania Health System, 3401 Market Street, Suite 320, Philadelphia, PA 19104-3308; e-mail, lsnyder@mail.acponline.org.

Requests for Bulk Reprints (minimum, 100 copies): the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Current Author Addresses: Dr. Caplan and Ms. Snyder: Center for Bioethics, University of Pennsylvania Health System, 3401 Market Street, Suite 320, Philadelphia, PA 19104-3308.

Dr. Faber-Langendoen: Program in Bioethics, SUNY Health Science Center, 750 East Adams Street, Syracuse, NY 13210.

Ann Intern Med. 2000;132(6):476-481. doi:10.7326/0003-4819-132-6-200003210-00009
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Oregon has legalized and implemented physician-assisted suicide, while observers argue about the moral import of attempting to formulate guidelines; the utility any set of guidelines can have for physician practice, health care providers, patients, or families; and whether guidelines can really protect against harm or abuse. What were once theoretical questions have taken on new urgency.

The debate over the value and power of guidelines includes the following questions: What has been the experience of efforts to implement physician-assisted suicide using consensus guidelines? What goals are guidelines intended to serve? Who should formulate guidelines? What features should be reflected in any proposed guidelines to make them practical and to permit achievement of their goals? Are there any fundamental obstacles to the creation or implementation of guidelines? Is dying a process that is amenable to direction under guidelines, be they issued by physicians, departments of health, blue ribbon panels, or other regulatory bodies? This paper explores these questions as physician-assisted suicide becomes legal.





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