Cambridge Quarterly of Healthcare Ethics

Special Section: Physician-Aided Death: The Escalating Debate

A Middle Ground on Physician-Assisted Suicide

James A. Tulskya1, Ann Alpersa2 and Bernard Loa3

a1 Assistant Professor of Medicine and Co-Director of the Program in Medical Ethics at Duck University Medical Center.

a2 Assistant Professor of Medicine and member of the Program in Medical Ethics, University of California, San Francisco.

a3 Professor of Medicine, Director of the program in Medical Ethics and the Robert Wood Johnson Clinical Scholars Program, University of California, San Francisco.

“[A] murder prosecution is a poor way to design an ethical and moral code for doctors,” observed the California Court of Appeal in 1983. Yet, physicians who have chosen to help terminally ill patients to commit suicide have trespassed on illegal ground. When skilled medical care fails to relieve the pain of terminally ill patients, some people believe that physicians may assist in these suicides. Others reject any kind of physician involvement. The debate on assisted suiczide and active euthanasia has focused on whether these acts can ever be acceptable. We propose to shift the debate to a less divisive issue: whether a caring physician who provides a suffering and ill patient with a prescription for a lethal dose of medication should be prosecuted as a felon. Even assisted suicide's opponents may object to such criminal prosecution. We propose to modify existing criminal laws to give physicians who assist their terminally ill patients in suicide, under carefully defined circumstances, a legal defense against criminal charges.