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

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 opinions 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

Table of Contents:
Acknowledgements List of Contributors Introduction. False Dichotomy versus Genuine Choice: The Argument over Physician-Assisted Dying Part I: Perspectives on Mercy, Nonabandonment, Autonomy, and Choice Chapter 1. The Quality of Mercy Chapter 2. Nonabandonment: A Central Obligation for Physicians Chapter 3. The Role of Autonomy in Choosing Physician Aid in Dying Chapter 4. Disability and Physician-Assisted Dying Chapter 5. When Suffering Patients Seek Death Part II: Clinical, Philosophical, and Religious Issues about the Ending of Life Chapter 6. Why Do People Seek Physician-Assisted Death? Chapter 7. Doctor-Patient Communication about Physician-Assisted Suicide Chapter 8. When Hastened Death Is Neither Killing Nor Letting Die Chapter 9. Physician-Assisted Suicide as a Last-Resort Option at the End of Life Chapter 10. Death: A Friend to Be Welcomed, Not an Enemy to Be Defeated Part III: Open Practice in a Legally Tolerant Environment Chapter 11. The Oregon Experience Chapter 12. The Distortion of Cases in Oregon Chapter 13. A Model That Integrates Assisted Dying with Excellent End-of-Life Care Chapter 14. Thirty Years' Experience with Euthanasia in the Netherlands: Focusing on the Patient as a Person Chapter 15. The Death of My Father Chapter 16. Assisted Death in the Netherlands: Physicians at the Bedside When Help Is Requested Part IV: Political and Legal Ferment Chapter 17. Political Strategy and Legal Change Chapter 18. Legal Advocacy to Improve Care and Expand Options at the End of Life Chapter 19. Physician-Assisted Suicide: Shifting the Focus from Means to Ends Chapter 20. Choice in Dying: A Political and Constitutional Context Chapter 21. Hastening Death: The Seven Deadly Sins of the Status Quo Conclusion. Excellent Palliative Care as the Standard, Physician-Assisted Dying as a Last Resort Index

About 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.

Review :
A very persuasive brief, combining empirical data, logical argumentation, and appeals to compassion. —JAMA 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 (Johns Hopkins University Press, 2002) would provide a thorough grounding in this issue. —Doody's Book Review Service 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. —New England Journal of Medicine 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. —Choice 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. —Humanist in Canada This is an excellent book for medical students, hospice personnel, and others involved in end-of-life care. —American Journal of Hospice and Palliative Medicine An important contribution to the debate as to whether the choice of assisted death should be granted to those who seek it. —Bulletin of Medical Ethics Provides a comprehensive account of the issue and will be of interest to professionals and patients at large. —Antonio Casado da Rocha, Metapsychology