Lois Snyder Sulmasy, JD; Paul S. Mueller, MD, MPH; for the Ethics, Professionalism and Human Rights Committee of the American College of Physicians *
Acknowledgment: The authors and the ACP Ethics, Professionalism and Human Rights Committee thank the many reviewers of the paper for helpful comments on drafts and Kathy Wynkoop for administrative assistance.
Financial Support: Exclusively from the ACP operating budget.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0938.
Requests for Single Reprints: Lois Snyder Sulmasy, JD, American College of Physicians, Center for Ethics and Professionalism, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, firstname.lastname@example.org.
Current Author Addresses: Ms. Snyder Sulmasy: American College of Physicians, Center for Ethics and Professionalism, 190 N. Independence Mall West, Philadelphia, PA 19106.
Dr. Mueller: Mayo Clinic, Gonda Building 17, 200 First Street Southwest, Rochester, MN 55905.
Author Contributions: Conception and design: P.S. Mueller.
Analysis and interpretation of the data: L. Snyder Sulmasy, P.S. Mueller.
Drafting of the article: L. Snyder Sulmasy, P.S. Mueller.
Critical revision for important intellectual content: P.S. Mueller.
Final approval of the article: L. Snyder Sulmasy, P.S. Mueller.
Administrative, technical, or logistic support: L. Snyder Sulmasy.
Collection and assembly of data: L. Snyder Sulmasy, P.S. Mueller.
Calls to legalize physician-assisted suicide have increased and public interest in the subject has grown in recent years despite ethical prohibitions. Many people have concerns about how they will die and the emphasis by medicine and society on intervention and cure has sometimes come at the expense of good end-of-life care. Some have advocated strongly, on the basis of autonomy, that physician-assisted suicide should be a legal option at the end of life. As a proponent of patient-centered care, the American College of Physicians (ACP) is attentive to all voices, including those who speak of the desire to control when and how life will end. However, the ACP believes that the ethical arguments against legalizing physician-assisted suicide remain the most compelling. On the basis of substantive ethics, clinical practice, policy, and other concerns articulated in this position paper, the ACP does not support legalization of physician-assisted suicide. It is problematic given the nature of the patient–physician relationship, affects trust in the relationship and in the profession, and fundamentally alters the medical profession's role in society. Furthermore, the principles at stake in this debate also underlie medicine's responsibilities regarding other issues and the physician's duties to provide care based on clinical judgment, evidence, and ethics. Society's focus at the end of life should be on efforts to address suffering and the needs of patients and families, including improving access to effective hospice and palliative care. The ACP remains committed to improving care for patients throughout and at the end of life.
Snyder Sulmasy L, Mueller PS, for the Ethics, Professionalism and Human Rights Committee of the American College of Physicians. Ethics and the Legalization of Physician-Assisted Suicide: An American College of Physicians Position Paper. Ann Intern Med. [Epub ahead of print 19 September 2017]167:576–578. doi: 10.7326/M17-0938
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Published: Ann Intern Med. 2017;167(8):576-578.
Published at www.annals.org on 19 September 2017
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