Physician-Assisted Suicide and Euthanasia in the ICU: A Dialogue on Core Ethical Issues

Crit Care Med. 2017 Feb;45(2):149-155. doi: 10.1097/CCM.0000000000001818.

Abstract

Objective: Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate.

Synthesis: We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting. We present areas of common ground and important unresolved differences.

Conclusions: We reached differing positions on the first three core ethical questions and achieved unanimity on how critical care clinicians should manage conscientious objections related to physician-assisted suicide and euthanasia. The alternative positions presented in this article may serve to promote open and informed dialogue within the critical care community.

MeSH terms

  • Attitude to Death
  • Euthanasia / ethics*
  • Humans
  • Intensive Care Units / ethics*
  • Intention
  • Morals
  • Physicians / ethics
  • Suicide, Assisted / ethics*
  • Withholding Treatment / ethics