Physician-Assisted Dying: The Case for Palliative Care and Patient Choice

Overview

Despite a growing consensus that effective palliative care should be a core element in the treatment of all terminally ill patients, challenging questions remain about the physician's role in helping suffering patients end their lives. Physician-assisted dying remains one of the most controversial issues facing doctors, lawmakers, and patients today, and the need for intelligent and informed opinion on both sides of the debate is greater than ever.

In this volume, a ...

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Overview

Despite a growing consensus that effective palliative care should be a core element in the treatment of all terminally ill patients, challenging questions remain about the physician's role in helping suffering patients end their lives. Physician-assisted dying remains one of the most controversial issues facing doctors, lawmakers, and patients today, and the need for intelligent and informed opinion on both sides of the debate is greater than ever.

In this volume, a distinguished group of physicians, ethicists, lawyers, and activists come together to present the case for the legalization of physician-assisted dying, for terminally ill patients who voluntarily request it. To counter the arguments and assumptions of those opposed to legalization of assisted suicide, the contributors examine ethical arguments concerning self-determination and the relief of suffering; analyze empirical data from Oregon and the Netherlands; describe their personal experiences as physicians, family members, and patients; assess the legal and ethical responsibilities of the physician; and discuss the role of pain, depression, faith, and dignity in this decision. Together, the essays in this volume present strong arguments for the ethical acceptance and legal recognition of the practice of physician-assisted dying as a last resort—not as an alternative to excellent palliative care but as an important possibility for patients who seek it.

Contributors: Marcia Angell, Anthony L. Back, Charles H. Baron, Andrew I. Batavia, Tom L. Beauchamp, Els Borst-Eilers, Dan W. Brock, Christine K. Cassel, Eric J. Cassel, Barbara Coombs-Lee, Linda Ganzini, Peter Goodwin, Martin Gunderson, Gerrit K. Kimsma, Sylvia A. Law, David Mayo, Alan Meisel, Robert A. Pearlman, Thomas Preston, John Shelby Spong, Helene Starks, Eli D. Stutsman, Kathryn L. Tucker, Johannes J. M. Van Delden, Herman H. van der Kloot Meijburg, Evert van Leeuwen, Jaap J. F. Visser

Johns Hopkins University Press

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Editorial Reviews

Metapsychology - Antonio Casado da Rocha
Provides a comprehensive account of the issue and will be of interest to professionals and patients at large.
Choice
This excellent book presents arguments supporting acceptance of physician-assisted death as an option for terminally ill patients who are suffering from extreme pain unrelieved by narcotics and whose only wish is to die.
New England Journal of Medicine
Readers who are interested in a balanced counterpoint highlighting the best arguments of advocates and opponents of the legalization of assisted suicide should read both Physician-Assisted Dying and Foley and Hendin's book.
JAMA
A very persuasive brief, combining empirical data, logical argumentation, and appeals to compassion.
Choice

This excellent book presents arguments supporting acceptance of physician-assisted death as an option for terminally ill patients who are suffering from extreme pain unrelieved by narcotics and whose only wish is to die.

American Journal of Hospice and Palliative Medicine
This is an excellent book for medical students, hospice personnel, and others involved in end-of-life care.
Humanist in Canada
The collection is the indispensable starting place for anyone wishing to become better informed about the present arguments over physician-assisted dying (especially in the United States), and it belongs in every high school, university, and medical library in the country.
Bulletin of Medical Ethics
An important contribution to the debate as to whether the choice of assisted death should be granted to those who seek it.
Metapsychology
Provides a comprehensive account of the issue and will be of interest to professionals and patients at large.

— Antonio Casado da Rocha

Doody's Review Service
Reviewer: Ryan B Spellecy, PhD (Medical College of Wisconsin Health Policy Institute)
Description: This is a much needed counterpart to a previous book, The Case Against Assisted Suicide: For the Right to End-of-Life Care, Foley, K. and Hendin, H. (Johns Hopkins University Press, 2002). The authors and perspectives contained in this book address the legal, political, philosophical, clinical, religious, and personal elements needed for a robust discussion of physician-assisted dying.
Purpose: The editors of this book, spurred by the publication of the The Case Against Assisted Suicide , wanted to counter what they argue are misconceptions and misunderstandings in the literature opposing physician assistance in dying that lead to a false dichotomy between palliative care and hospice or physician-assisted dying at the end of life. To counter this false dichotomy, the editors sought to assemble the best arguments in favor of choice at the end of life, and they have done just that.
Audience: The editors are simply the leading authorities in favor of the legalization and regulation of physician-assisted suicide as a means to choice in dying. By assembling a wide range of contributors, this book will find a welcome audience in clinicians, bioethicists, philosophers, students, policy makers, lawyers, and the like who seek a careful, honest exploration of choice at the end of life.
Features: This is a very complete discussion in favor of choice at the end of life. The centrality of autonomy in the contest of the physician/patient relationship as a relationship between two people that must include mercy and non-abandonment is discussed. There is also a rich, informed understanding of why patients seek assistance in dying, a rigorous analysis of key philosophical concepts in the debate, and a discussion of data from both Oregon and the Netherlands of the practice of physician-assisted suicide.
Assessment: This is an excellent addition to the debate surrounding physician-assisted suicide and choice at the end of life. Reading this book along with The Case Against Assisted Suicide would provide a thorough grounding in this issue.

5 Stars! from Doody
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Product Details

  • ISBN-13: 9780801880698
  • Publisher: Johns Hopkins University Press
  • Publication date: 12/1/2004
  • Pages: 320
  • Product dimensions: 6.22 (w) x 9.18 (h) x 1.14 (d)

Meet the Author

Timothy E. Quill, M.D., is a professor of medicine, psychiatry, and medical humanities at the University of Rochester and author of A Midwife through the Dying Process, also available from Johns Hopkins. Margaret P. Battin, Ph.D., is Distinguished Professor of Philosophy and an adjunct professor of medical ethics at the University of Utah. She is the author of The Least Worst Death.

Johns Hopkins University Press

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Table of Contents

Introduction : false dichotomy versus genuine choice : the argument over physician-assisted dying 1
1 The quality of mercy 15
2 Nonabandonment : a central obligation for physicians 24
3 The role of autonomy in choosing physician aid in dying 39
4 Disability and physician-assisted dying 55
5 When suffering patients seek death 75
6 Why do people seek physician-assisted death? 91
7 Doctor-patient communication about physician-assisted suicide 102
8 When hastened death is neither killing nor letting die 118
9 Physician-assisted suicide as a last-resort option at the end of life 130
10 Death : a friend to be welcomed, not an enemy to be defeated 150
11 The Oregon experience 165
12 The distortion of cases in Oregon 184
13 A model that integrates assisted dying with excellent end-of-life care 190
14 Thirty years' experience with euthanasia in the Netherlands : focusing on the patient as a person 202
15 The death of my father 217
16 Assisted death in the Netherlands : physicians at the bedside when help is requested 221
17 Political strategy and legal change 245
18 Legal advocacy to improve care and expand options at the end of life 264
19 Physician-assisted suicide : shifting the focus from means to ends 282
20 Choice in dying : a political and constitutional context 300
21 Hastening death : the seven deadly sins of the status quo 309
Conclusion : excellent palliative care as the standard, physician-assisted dying as a last resort 323
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