AMA Journal of Ethics®

Illuminating the art of medicine

Journal of Ethics Header

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. January 2005, Volume 7, Number 1.

Module 5

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Case 5.2: Physician Assisted Suicide and Euthanasia—Mrs. Scott's Plan for the Future

Related topic: Euthanasia

Euthanasia, a cousin to physician-assisted suicide, is also prohibited by the Code.

Opinion 2.21, "Euthanasia"

Euthanasia is the administration of a lethal agent by another person to a patient for the purpose of relieving the patient's intolerable and incurable suffering. It is understandable, though tragic, that some patients in extreme duress— such as those suffering from a terminal, painful, debilitating illness—may come to decide that death is preferable to life. However, permitting physicians to engage in euthanasia would ultimately cause more harm than good. Euthanasia is fundamentally incompatible with the physician's role as healer, would be difficult or impossible to control, and would pose serious societal risks.

...The physician who performs euthanasia assumes unique responsibility for the act of ending the patient's life...Instead of engaging in euthanasia, physicians must aggressively respond to the needs of patients at the end of life. Patients should not be abandoned once it is determined that cure is impossible. Patients near the end of life must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication.

There may be cases where a patient's pain and suffering are not reduced to tolerable levels and the patient requests a physician's help to die. If a physician cannot ease the pain and suffering of a patient by means short of death, using medical expertise to aid an "easy" death may seem to be the humane and appropriate treatment for the patient. But the prohibition against medically killing patients is a strong and lasting tradition in medical ethics that is based upon a professional commitment to healing.

Weakening the prohibition against euthanasia, even in the most compelling situations, has troubling implications. Though the magnitude of such risks are impossible to predict accurately, the medical profession and society as a whole must not consider these risks lightly. Condoning euthanasia by physicians might undermine public trust in medicine's dedication to preserving the life and health of patients. Moreover, in a society that condones euthanasia, some patients may fear the prospect of involuntary or nonvoluntary euthanasia if they think their lives are no longer deemed valuable by others.

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