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Conclusions: Psychosocial and psychiatric issues are among the most powerful predictors of desire for death and interest in PAS.
Nevertheless, the Court’s decision suggested that while laws prohibiting PAS were not unconstitutional, neither were laws The arguments supporting legalization of euthanasia/PAS are substantial.
Proponents perceive PAS as an act of humanity toward the terminally ill patient.
Introduction Palliative care and quality-of-life issues in patients with advanced cancer and AIDS have become an important area of clinical care and investigation.
Significant progress has been made in extending a palliative care/quality of life research agenda to the clinical problems of patients with cancer,1 including efforts that focus on such mental health-related issues as neuropsychiatric syndromes and psychologic symptoms in patients with advanced cancer and AIDS.2 Perhaps the most compelling and clinically relevant mental health issues in palliative care today, however, concern the desire for death and physician-assisted suicide (PAS) and their relationship to depression.
This distinction has had the effect of allowing a patient on life support the ability to end his or her life on request, yet a patient who is not dependent on life support does not have such a right.
In fact, this difference in perceived "rights" formed the basis of the arguments made to the Supreme Court in Washington v Glucksberg9 and Quill v Vacco,10 in which it was argued that this distinction violated the due process clause of the 14th Amendment (the Supreme Court unanimously rejected this argument).
Both euthanasia and PAS have been distinguished, legally and ethically, from the administration of high-dose pain medication meant to relieve a patient’s pain that may hasten death (often referred to as the rule of double effect) or even the withdrawal of life support.6,7 The distinction between euthanasia/PAS and the administration of high-dose pain medications that may hasten death is premised on the intent behind the act.
In euthanasia/PAS, the intent is to end the patient’s life, while in the administration of pain medications that may also hasten death, the intent is to relieve suffering.
They believe the patient and family should not be forced to suffer through a long and painful death, even if the only way to alleviate the suffering is through suicide.
To the advocate for PAS, legalization of PAS is a natural extension of patient autonomy and the right to determine what treatments are accepted or refused.