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Medicine and Public Policy |

Should Assisted Suicide Be Only Physician Assisted?

Kathy Faber-Langendoen, MD; Jason H.T. Karlawish, MD, University of Pennsylvania Center for Bioethics Assisted Suicide Consensus Panel
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From SUNY Health Science Center, Syracuse, New York; and University of Pennsylvania, Philadelphia, Pennsylvania.

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 Kathy Faber-Langendoen, MD, and Jason Karlawish, MD. Members of the Assisted Suicide Consensus Panel were: Arthur L. 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). Barbara Coombs Lee, Lois Snyder, and Timothy E. Quill dissented from the paper. 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. Dr. Karlawish is supported by a Brookdale Foundation National Fellowship and National Institute on Aging grant 1K01-AG00931.

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

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

Dr. Karlawish: University of Pennsylvania, Institute on Aging, 3615 Chestnut Street, Philadelphia, PA 19104.

Ann Intern Med. 2000;132(6):482-487. doi:10.7326/0003-4819-132-6-200003210-00010
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Discussions in the media, courts, legislatures, and professional societies generally assume assistance with suicide to be a physician's task; in these venues it is commonly referred to as “physician-assisted suicide.” This paper defines both the necessity and the limits of the physician's role in assisted suicide by asking the question: Should assisted suicide be only physician assisted? Although physician involvement is necessary, we argue that it is not sufficient to ensure that patients requesting assisted suicide receive the best care. Assisted suicide requires physician involvement, but physicians' limited competence in performing the full range of tasks, the competencies of other professions, and the possibility that other professions could expand their authority in this area suggest that physician-assisted suicide is a far too narrow construct of the task. The willingness of other professionals—including nurses, social workers, and clergy—to participate and even take the lead in assisting suicides is critical to meet society's interest that assisted suicide should be humane, effective, and confined to appropriate cases. As long as legislation and guidelines focus exclusively on the physician's role, our laws and regulations will fall short of meeting societal expectations.





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