Physician assisted suicide: a second view from Mid-Atlantic.

Abstract

The concept of physician assisted suicide (PAS) raises fundamental legal and moral questions. In this article we look at its current position in the United States and the United Kingdom, at on-going efforts to decriminalize it, and at arguments in favour of and against such proposals. We also offer our own cautious views. In this article, we limit the practice of PAS to those instances where a competent adult earnestly requests assistance in dying from his or her physician during the last stages of an intolerable and terminal illness and, as a consequence, the physician prescribes a lethal drug or provides other facilities by which the patient may end his or her life. The only exception lies in those instances where the patient is physically unable to make use of the help given; in such circumstances, our definition would include active participation by the physician. “Terminal illness”, however, has no precise meaning. The United States’ Uniform Rights of the Terminally Ill Statute’ requires that death is expected “in a relatively short time” which is, itself, inexact but which has the advantage of eliminating tedious arguments as to precision. We are happy, for present purposes, to interpret it as referring to an incurable illness which, within reasonable medical certainty, is expected to bring about death within approximately six months regardless of medical intervention. The definition of PAS itself is one to be considered carefully. Must it, inevitably, include more than merely ”leaving the pills”? Take, at one extreme, the doctor who disconnects the ventilator when asked to do so in, say, an advanced case of motor neurone disease is this to be classed as withdrawal of treatment at the patient’s request or as assisted suicide? Or, at the other extreme, what of the physician who performs the venepuncture and holds the syringe of potassium