Physician assisted death in vulnerable populations

Physician assisted death (both voluntary active euthanasia and physician assisted suicide) has been openly practised in the Netherlands for more than 25 years and formally legalised since 2002. The practice has been analysed in four major national studies between 1990 and 2007.1 2 A more restricted form of physician assisted death (physician assisted suicide only) was legalised in Oregon in 1997 and is the subject of an annual report (www.oregon.gov/DHS/ph/pas/index.shtml). Although these studies do little to resolve the moral and religious questions surrounding these practices, they do answer the following questions about the risks and benefits of legalisation.

Will these practices become more common over time in a permissive environment? In Oregon, physician assisted death accounts for around one in 1000 deaths each year, with no significant change in frequency over nine years. All patients have met the necessary criteria, and more than 85% were also enrolled in hospice programmes. In Oregon, one in 50 dying patients talk to their doctors about assisted death and one in six talk to family members.3 There seems to be much conversation about end of life options, therefore, but relatively few cases of assisted death. Oregon is among the nation's leaders in …