Case and Commentary
Jan 2005
A. Prescribing the barbiturates and informing Mrs. Scott of the appropriate dosing levels potentially makes Dr. Lee an accessory to Mrs. Scott's suicide and, so, should be avoided; it also violates the Code in Opinion 2.211, "Physician-Assisted Suicide": "Physician-assisted suicide is fundamentally incompatible with the physician's role as healer."
B. Informing Mrs. Scott that he will not prescribe barbiturates for the reasons she has suggested—he will not take part in physician-assisted suicide—is supported by the Code in Opinion 2.211, "Physician-Assisted Suicide": "Physician-assisted suicide is fundamentally incompatible with the physician's role as healer, would be difficult or impossible to control, and would pose serious societal risks." Further, offering to prescribe analgesics or opioids to alleviate her pain and suffering is preferable and is also supported in Opinion 2.211, "Physician-Assisted Suicide": "physicians must aggressively respond to the needs of patients at the end of life...Patients near the end of life must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication."
C. Informing Mrs. Scott that she will have to ask another physician for assistance in ending her life and referring her to other physicians should be avoided and is not supported by the Code. Opinion 2.211, "Physician-Assisted Suicide" states: "physicians must aggressively respond to the needs of patients at the end of life...Patients near the end of life must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication."
D. Recommending Mrs. Scott see a counselor, either pastoral or otherwise, or undergo a psychological evaluation is acceptable and is supported by the Code in Opinion 2.211, "Physician-Assisted Suicide": "Multidisciplinary interventions should be sought, including specialty consultation, hospice care, pastoral support, family counseling, and other modalities." This course of action, however, may not be warranted at this point.
