A good question to ask is, Why did 21 of the 44 patients who obtained lethal prescriptions use them? What was done to identify the causes of suffering that prompted the requests for lethal prescriptions? How much compassion was extended in the alleviation of the suffering and fear of the patients and their families?
Society might be better served by addressing the reasons why patients seek assistance with suicide. Consideration should involve assessment of the patient's family, finances, and legal affairs, and we should examine where and by whom care will be provided, how household chores will be managed, and how care will be provided to the patient's dependents and pets. Patients at the end of life need aggressive symptom management, aids that optimize functioning, the right to determine medical care, and assistance in using the Patient Self-Determination Act.
Acknowledging the fear of suffering, loss of control, pain, being a burden, indignity, and abandonment can lead to excellent nursing and medical care at the end of life. Educating the public and using alternatives to physcianassisted suicide can more effectively provide peace and dignity during end-of-life care.
Diana M. L. Newman, EdD, RN
Boston, MA
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Editor's note: Following the March Viewpoint, The War on Assisted Suicide, by Judith Kennedy Schwarz, a federal judge on April 17 in Portland, Oregon, upheld the state's Death with Dignity Act, which Attorney General John Ashcroft had attempted to overturn in November, claiming it violated the federal Controlled Substances Act. The Justice Department is reviewing the ruling and is considering an appeal.