ACP Reaffirms Position Against Physician-Assisted Suicide

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

The American College of Physicians has reaffirmed its stance against the legalization of physician-assisted suicide.

In a position paper in the Annals of Internal Medicine, the group says its "main concerns in the debate are ethical ones." In particular, "the patient–physician relationship is inherently unequal," and "physicians can influence patients, even in ways physicians may not appreciate."

The College says physicians should instead focus on improving end-of-life care. "Requests for physician-assisted suicide are unlikely to persist when compassionate supportive care is provided," they note. To that end, the ACP recommends that physicians follow 12 steps when a patient requests physician-assisted suicide. These include:

• Talk with the patient about the reasons for the request and explore alternatives.

• Reassure the patient that you will not abandon him or her during end-of-life care.

• Facilitate advance care planning.

• Make sure the patient understands his or her right to refuse treatments.