Guest Editorial by: You

Your commentary is so interesting that I have printed most of it. So, for once, readers of SSV Medicine are our guest editor. While opinions were closely divided, those who consider limited physician-assisted suicide ethical have written most. Please forgive my own editing for space, it's not personal! Complete comments will be posted in the online version of SSV Medicine.
- John Loofbourow, Editor

"In very rare situations, I think a physician may consider assisting a patient...suicide... another physician should provide an independent second opinion...family must be notified and agree..."
- George Chiu

"It all depends on the definition of the word 'assist.' Does that sound familiar? If a physician provides a pain-ridden terminally ill patient with a prescription for drugs (and) if the patient ingests the entire quantity…even if the physician suspects that might occur, I see it as ethical prescribing. I think it is unethical to attend the patient during a directed suicide event."
- Jim Hamill

"It is usually unethical for a physcian to assist a patient in committing suicide, but there may be exceptions..."
- Walton Brainerd

"Only if the patient has a well documented terminal condition and is in pain and has undergone a psychiatric evaluation."
- Karyl Andolina

"There are circumstances when the relief of suffering outweighs waiting for natural death."
-Irma West

"If a given patient wishes to commit suicide in the setting of untreatable suffering or pain, I still find it problematic for a physician to actively participate....I'd be most comfortable...in the context of meaning and purpose - (by) involving biologic and extended family, the person's spiritual community to the extent to which it might exist....I realize that others might not find active participation in assisted suicide a problem. I don't pretend to want to ... criticize them....I would personally choose not to actively participate..."
- Mark Robinson

"Would I want this assistance myself?....Yes!!"
- E T Rulison, Jr

"Physicians should offer this service to their patients."
- Bette Hinton

"(This) question...(is) hard to answer...providing adequate analgesia for a terminal patient may hasten death, and may have a secondary goal of 'assisted suicide'....a similar request from a (young) depressed patient is...very different..."
- Malathi Srinivasan

"It is not unethical for a physician to relieve a patient's severe pain or dyspnea, even if this suppresses respiratory drive and may hasten...death, if in the medical opinion of the physician, and in discussion and concurrance with the patient, the patient has a terminal illness....I do not believe these actions are suicide, assisted or otherwise. They are appropriate medical management of death and dying."
- Alan Siefkin

"Patients have a right to die the way they want and there is such a thing as 'rational' suicide."
- Richard Beyer

"This, from the perspective of ethical principles, falls within the realm of do no harm relative to pain and suffering."
- Thom Atkins

"Physicians should remain true to the professional goal...assisting patients (with) illness that cannot be cured. That does not preclude patients from independently choosing suicide and even using medications intended for treatment in that effort. However, it goes against the role of the physician to be complicit in that effort, particularly as the issues are often complex and cannot be fully known to the physician."
- Karen Tait

"Maybe for help dying you should have an official Death Easer, but not a physician "
- Max Sudhoff

"I would do everything possible to explore and avoid this path, but can honestly accept that there may be rare circumstances that the ethical and humane path would include assisting death at the door."
- Marion Leff

"I can imagine certain medical situations where assisted suicide would be humane and appropriate."
- Ruth Haskins

"The physician's duty is to assist the patient in managing his health problems. (Where) suicide is in the patient's best interest, we should use our expertise in making this final phase of his/her life as easy and comfortable and clean as possible. This is not "playing God" any more than is combating disease."
- Kevin Ryan

"The question is, are there patient conditions so intolerable, despite our best treatment, that death is preferable to continuing suffering?"
- Lee Welter

"I believe euthanasia is an important part of the practice of medicine."
- Wim and Pauley Van Muyden

"While I personally find this area of medicine unsavory...I can see certain physicians with appropriate training and controls...might consider this and it could, therefore, be considered ethical. Oregon and I think either Netherlands or Denmark currently have processes along these lines."
- Warner Hudson

"...it is unethical to do something that is proscribed by the law of the land. However, under carefully evaluated circumstances, I can also imagine situations in which physician-assisted suicide could be considered ethical if not morally imperative. "
- Paul Phinney

"...there are many issues that need to be addressed, that the patient is competent, not depressed, that the family and money issues or lack of care or pain management are not issues. I would not want to see physicians managing this all alone, but in a caring environment for patient and physician with careful protocols..."
- Andy Hedin

"I think that physician-assisted suicide is necessary. "
- Lisa Wang

lufboro@jps.net