Facing requests for physician-assisted suicide: toward a practical and principled clinical skill set

JAMA. 1998 Aug 19;280(7):643-7. doi: 10.1001/jama.280.7.643.


Requests for physician-assisted suicide are not a new phenomenon, and many physicians are likely to face this challenging situation. This article proposes for professionals an 8-step approach to respond to requests for physician-assisted suicide. The approach seeks to identify and treat the root causes of the request and aims to present a plan for consistent application of a set of clinical skills. Justification for the steps requires only 2 noncontentious principles: the patient should be free of unwanted intervention, and the physician is obligated to provide suffering patients with comfort care. Care based on these 2 principles alone does not include physician-assisted suicide. The approach does, however, justify patient refusal of oral intake in specific circumstances. The approach could resolve a majority of requests for physician-assisted suicide and should be tested further for clinical efficacy.

MeSH terms

  • Advance Care Planning
  • Clinical Competence*
  • Decision Trees*
  • Ethics, Medical
  • Humans
  • Moral Obligations
  • Personal Autonomy
  • Stress, Psychological
  • Suicide, Assisted*
  • Withholding Treatment