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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
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
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
Competing interests: No competing interests