Physician-Assisted Suicide — NEJM

<div class="section case-vignette" style="margin: 0px 0px 15px; padding: 0px; border-width: 0px 0px 1px; border-bottom-style: solid; border-bottom-color: rgb(204, 204, 204); outline: 0px; font-weight: normal; font-style: normal; font-size: 16px; vertical-align: baseline; color: rgb(51, 51, 51); font-family: arial, sans-serif; font-variant: normal; letter-spacing: normal; line-height: 16px; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255);"><h3 id="articleCase Vignette" style="margin: 0px 0px 4px; padding: 0px; border: 0px; outline: 0px; font-weight: bold; font-style: normal; font-size: 0.875em; vertical-align: baseline; text-transform: uppercase; font-variant: normal; line-height: normal; font-family: arial;">CASE VIGNETTE</h3><div style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 15px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; outline-width: 0px; outline-style: initial; outline-color: initial; font-weight: inherit; font-style: inherit; font-size: 0.813em; vertical-align: baseline; line-height: 1.4em; ">John Wallace is a 72-year-old man with metastatic pancreatic cancer. At time of diagnosis, the cancer was metastatic to his regional lymph nodes and liver. He was treated with palliative chemotherapy, but the disease continued to progress. Recently he has become jaundiced, and he has very little appetite. He has been seeing a palliative care physician and a social worker on an ongoing basis. His abdominal pain is now well controlled with high-dose narcotics, but the narcotics have caused constipation. In addition to seeing the social worker, he has also been seeing a psychologist to help him to cope with his illness.</div><div style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 15px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; outline-width: 0px; outline-style: initial; outline-color: initial; font-weight: inherit; font-style: inherit; font-size: 0.813em; vertical-align: baseline; line-height: 1.4em; ">Mr. Wallace has been married to his wife, Joyce, for 51 years, and they have three children and six grandchildren. He and his wife have lived in Salem, Oregon, for the past 23 years, and most of his family lives nearby. He understands the prognosis of the disease, and he does not wish to spend his last days suffering or in an unresponsive state. He discusses his desire for euthanasia with his wife and family members, and they offer him their support. The next day, he calls his physician and asks for information about physician-assisted suicide.</div></div><div class="section" style="margin: 0px 0px 15px; padding: 0px; border: 0px; outline: 0px; font-weight: normal; font-style: normal; font-size: 16px; vertical-align: baseline; color: rgb(51, 51, 51); font-family: arial, sans-serif; font-variant: normal; letter-spacing: normal; line-height: 16px; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255);"></div><div class="section treatment-options" style="margin: 0px 0px 5px; padding: 0px; border: 0px; outline: 0px; font-weight: normal; font-style: normal; font-size: 16px; vertical-align: baseline; color: rgb(51, 51, 51); font-family: arial, sans-serif; font-variant: normal; letter-spacing: normal; line-height: 16px; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255);"><h3 id="articleRecommendations" style="margin: 0px 0px 4px; padding: 0px; border: 0px; outline: 0px; font-weight: bold; font-style: normal; font-size: 0.875em; vertical-align: baseline; text-transform: uppercase; font-variant: normal; line-height: normal; font-family: arial;">TREATMENT OPTIONS</h3><div style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 15px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; outline-width: 0px; outline-style: initial; outline-color: initial; font-weight: inherit; font-style: inherit; font-size: 0.813em; vertical-align: baseline; line-height: 1.4em; ">Do you believe that Mr. Wallace should be able to receive life-terminating drugs from his physician? Which one of the following approaches to the broader issue do you find appropriate? Base your choice on the published literature, your own experience, and other sources of information.</div><div style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 15px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; outline-width: 0px; outline-style: initial; outline-color: initial; font-weight: inherit; font-style: inherit; font-size: 0.813em; vertical-align: baseline; line-height: 1.4em; ">To aid in your decision making, each of these approaches is defended in the following short essays by experts in the field. Given your knowledge of the patient and the points made by the experts, which option would you choose? Make your choice and offer your comments at <a href="http://NEJM.org">NEJM.org</a>.</div></div><ul class="treatment-options-list" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: normal; font-style: normal; font-size: 16px; vertical-align: baseline; list-style: none; color: rgb(51, 51, 51); font-family: arial, sans-serif; font-variant: normal; letter-spacing: normal; line-height: 16px; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255);"><li class="firstChild" style="margin: 0px; padding: 0px 0px 5px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 0.7em; vertical-align: baseline;"><strong style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: bold; font-style: inherit; font-size: 11px; vertical-align: baseline;">Option 1</strong>: Physician-Assisted Suicide Should Not Be Permitted</li><li class="lastChild" style="margin: 0px; padding: 0px 0px 5px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 0.7em; vertical-align: baseline;"><strong style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: bold; font-style: inherit; font-size: 11px; vertical-align: baseline;">Option 2</strong>: Physician-Assisted Suicide Should Be Permitted</li></ul><br><a href="http://www.nejm.org/doi/full/10.1056/NEJMclde1302615#t=cldeOpt2">http://www.nejm.org/doi/full/10.1056/NEJMclde1302615#t=cldeOpt2</a>

Physician-Assisted Suicide — NEJM

CASE VIGNETTE John Wallace is a 72-year-old man with metastatic pancreatic cancer. At time of diagnosis, the cancer was metastatic to his re...

Read more »