Skip Navigation LinksHome > April 2014 - Volume 27 - Issue 2 > Physician aid-in-dying: cautionary words
Current Opinion in Anaesthesiology:
doi: 10.1097/ACO.0000000000000046
ETHICS, ECONOMICS AND OUTCOME: Edited by David M. Rothenberg

Physician aid-in-dying: cautionary words

Van Norman, Gail A.a,b

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Abstract

Purpose of review

Physician-assisted suicide (PAS) and euthanasia have been increasingly discussed in end-of-life care, as PAS and euthanasia have now been legalized in three European countries and PAS has been legalized in Washington, Oregon, and Montana in the USA. This review focuses on some aspects of PAS and euthanasia and discusses deep terminal sedation (DTS), which is increasingly used to treat intractable symptoms at the end of life.

Recent findings

PAS and euthanasia present potential risks for vulnerable populations, such as the depressed and disabled. The Oregon experience does not allow specific analysis regarding disabled patients, but fewer psychiatric consultations are being done to evaluate patients for depression. In the Netherlands, a small number of patients undergo euthanasia without an explicit request. Twenty percent of cases go unreported, raising questions of whether they met legal standards. The use of DTS in all countries has increased, but in a significant number of cases, DTS is used with an explicit intent to hasten death. Double-effect arguments to justify DTS may not actually apply.

Summary

Caution is warranted regarding PAS and euthanasia, as vulnerable patients may still be at risk. More research is needed to characterize the use (and misuse) of DTS.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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