JAMA Viewpoint: 'Physician-assisted dying: A turning point?'

The debate over physician-assisted death (PAD) appears to be at a turning point, with a significant number of state legislatures across the country considering PAD, say two Georgetown University scholars, but, they caution, social and ethical safeguards are needed.

In a JAMA Viewpoint published online today, Lawrence O. Gostin and Anna E. Roberts of Georgetown's O'Neill Institute for National and Global Health Law, examine state laws surrounding physician-assisted death, their constitutionality, the practice of "death with dignity," its impact on public opinion, and the potential for abuse of legalized physician assisted suicide.

In 1997, the U.S. Supreme Court ruled that the federal government could not prohibit physicians from prescribing controlled drugs to assist patient deaths if authorized under state law. This ruling led to numerous states permitting PAD including Oregon, Washington, Montana, Vermont and California.

Decades of research have focused on whether physician assisted death has been misused and whether gaps exist in legislative safeguards.

"There are multiple concerns with physicians assisting patients to die: incompatibility with the physician's role as a healer, devaluation of human life, coercion of vulnerable individuals (e.g., the poor and disabled), and the risk that PAD will be used beyond a narrow group of terminally ill individuals," write Gostin and Roberts.

"...PAD is a deeply personal choice. The question is whether more states will authorize the practice and, if so, what safeguards will be put in place to ensure the practice is not misused and remains consistent with prevailing social and ethical thought," they write.