The Right to Assisted Suicide - Lone Star College
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Palliative care–including excellent pain and symptom management, psychosocial support for patients and families, and assistance with difficult decision-making–should be part of the standard of care for all seriously ill patients. Many studies have demonstrated a significant gap between the potential of palliative treatments to relieve suffering and actual practice. If someone considers PAD, the first step should be for doctors to ensure that the patient is receiving optimal palliative treatment. But even with the best possible palliative care and support there will likely be a small percentage of cases where symptoms become intractable despite skillful efforts to help. Furthermore, patient suffering cannot be restricted to the physical realm and must include psychological, social, existential, and spiritual dimensions. The medical profession acknowledges that such unacceptable suffering sometimes exists when physicians talk with patients about stopping life supports, but when there is no life support to stop, the medical profession may assume that both the patient and the physician have not tried hard enough with standard palliative measures. The more that nonphysical suffering predominates, the less consensus there is about a patient’s right to die by any means. In circumstances of intractable patient suffering, there is evidence that some physicians in the U.S. sometimes assist in patients’ deaths. This is not easily studied because to acknowledge participation a physician must admit to a crime in most jurisdictions. Nonetheless, several imperfect studies of the practice in the U.S. suggest that in states where PAD is illegal it may account for as many as 1-2% of deaths.
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Some controversy remains about what to call the practice. Common understanding of the word suicide equates it with mental illness and irrational behavior, and the medical obligation would therefore be to prevent these acts if at all possible. Dying patients who see their lives being destroyed by illness sometimes come to view death as the only way to escape their suffering, and therefore view it as a means of self-preservation – the opposite of suicide. The states where it has become legalized now call it physician-assisted death or physician aid-in-dying.