Physician-Assisted Suicide

In 1997, Oregon became the first state in the United States to pass legislation that offered a “physician-assisted” approach to dying for terminally-ill adults. Sixteen years later and physician-assisted suicide continues to be a widely debated topic.

Supporters submit that for competent, terminally ill adults, having assisted suicide as an option allows them to take control over their lives and is a compassionate response to their suffering.

Opponents argue that allowing physicians to help terminally ill patients end their lives fosters an environment where the focus is no longer on making these patients comfortable, but in forcing them to choose between suffering and suicide.

Opinions by the Numbers

In a Sermo Physician Poll conducted in May of this year, 48% of physicians thought assisted suicide should be legalized, while 38% were opposed and 14% were undecided.  What’s interesting is if you tease out the numbers by physician specialty.  See below for some comparisons …

However, in a poll conducted by the New England Journal of Medicine in September, 67% of US readers were against physician-assisted suicide. When broken down by state, 18 states were in favor of legalizing assisted suicide, an important fact given that legality is determined by the individual states in the USA.

Current Legislation

While physician opinion remains split, Oregon, Washington, Montana, and Vermont now allow mentally competent, terminally ill patients to legally obtain medications which can be used to terminate their lives.

In a study published in The New England Journal of Medicine, researchers analyzed the Death with Dignity program at the Seattle Cancer Care Alliance from 2009 to 2011. By December 2011, 255 patients had participated in the Death with Dignity program. The most common reasons given by patients for wanting to participate were loss of autonomy (97.2%), inability to engage in enjoyable activities (88.9%), and loss of dignity (75.0%).

As the U.S. population continues to age and healthcare costs continue to rise, it stands to reason that physician-assisted suicide will continue to be a much-discussed topic in the future.

If you live, or were to live, in a state that allowed physician-assisted suicide, how would you address this with terminally ill patients? Would you mention it to all patients with a terminal diagnosis, or only if the patient approached the topic themselves? If you’re an M.D. or a D.O. we’ll be discussing this more inside Sermo, please join us.