Concern over suicide law should be about access to best end-of-life care -- not few psychiatric consults

LETTER — Posted May 2, 2005

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Regarding "Oregon sees fewer numbers of physician-assisted suicides" (Article, April 4): I found the article on physician assisted suicide in Oregon very helpful. I expect that the concern over the lack of psychiatric consultations is unwarranted and that the real concern (and therefore a focus of data collection) should be on referral to a palliative care specialist and hospice program.

I looked over the list of reasons people requested physician-assisted suicide (less able to engage in activities that make life enjoyable; losing autonomy; loss of dignity; losing control of bodily functions; burden on family, friends, caregivers; inadequate pain control or concern about pain; and financial implications of treatment) and they all strike me as areas of intervention for hospice and palliative care professionals, not psychiatrists.

So it seems to me that perhaps the focus in Oregon and the rest of the states should be on making excellent end-of-life care a higher priority, rather than just condemning those who are making terribly difficult decisions under terribly difficult circumstances. We physicians have to make ourselves better at providing excellent care for these patients.

Christopher M. Hughes, MD, Pittsburgh

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/05/02/edlt0502.htm.

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