Rapid Responses to:

ANALYSIS: Stephen J Ziegler and Georg Bosshard Role of non-governmental organisations in physician assisted suicide BMJ 2007; 334: 295-298 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Physician assisted suicide in Oregon : issues of autonomy and moral agency

David Jeffrey   (12 February 2007)

Physician assisted suicide in Oregon : issues of autonomy and moral agency 12 February 2007
David Jeffrey, Consultant in palliative medicine Borders General Hospital, Melrose Roxburghshire.TD6 0SD Send response to journal: Re: Physician assisted suicide in Oregon : issues of autonomy and moral agency	Ziegler and Bossard fail to clarify that the 30 people who use physician-assisted suicide each year in Oregon are not “suffering unbearably”, they are not in pain ,nor are they depressed .1,2 This tiny but significant group have a need for control, they want to choose the time of their death and have little interest in receiving palliative or hospice care. Oregon physicians described patients requesting physician assisted suicide as having strong and vivid personalities characterized by determination and inflexibility .3 The option to have physician assisted suicide in Oregon is widely perceived by the public as a safety net. The need for this safety net is fuelled by a lack of trust in their health care system.2,4 Assisted suicide cannot take place without a lethal prescription from the doctor. Thus the doctor’s moral agency is not “limited” as Zeigler and Bossard suggest. 1 The doctor is necessarily involved in a form of medicalised killing. The moral agencies of the family, nurses and pharmacists in assisted suicide are also relevant in the debate. Hospice programs in Oregon allow their staff to support a patient who intends assisted suicide, they do not permit their doctors to write lethal scripts. The hospice nurse will “take a walk around the block” while the patient takes the medication and return to support the family. 2 At a time when our society is trying to limit killing by control of guns and rejecting war, there is no sound reason to legalise assisted suicide. David Jeffrey Consultant in palliative medicine, Borders General Hospital, Melrose Roxburghshire.TD6 0SD ellemford2004@yahoo.co.uk Competing interest :Winston Churchill Traveling Fellowship 2006 1 Ziegler S, Bossard G, Role of non-governmental organizations in physician assisted suicide. BMJ 2007 ;334:295-298. 2 Jeffrey D Physician-assisted suicide v palliative care: A tale of two cities. Report of Winston Churchill Traveling Fellowship 2006. http://www.wcmt.org.uk/reportfiles/medical-and-health/831_ (accessed 9th February 2007) 3 Ganzini L, Dobscha SK, Heintz RT ,Press N Oregon Physicians’ Perceptions of Patients Who Request Assisted Suicide and Their Families J Palliative Medicine 2003;6:381-390. 4 Ganzini L, Beer TM, Brouns M, Mori M, Hsieh YC. Interest in Physician- Assisted suicide among Oregon Cancer Patients J Clinical Ethics 2006 ;17:27-45 Competing interests: Winston Churchill Traveling Fellowship 2006