Furthermore, a physician who withdraws, or honors a patient’s refusal to begin life-sustaining medical treatment purposefully intends, or may so intend, only to respect his patient’s wishes and to cease doing useless and futile or degrading things to the patient when the patient no longer stands to benefit from them. The same is true when a doctor provides aggressive palliative care; in some cases, painkilling drugs may hasten a patient’s death, but the physician’s purpose and intent is, or may be, to ease his patient’s pain only.
A doctor who assists a suicide, however, "must, necessarily, and indubitably, intend primarily that the patient be made dead." Similarly, a patient who commits suicide with a doctor’s aid necessarily has the specific intent to end his or her own life, while a patient who refuses or discontinues treatment might not. In holding that there is no fundamental right to physician-assisted suicide, the U.S. Supreme Court nonetheless left open to the individual states the continuing debate over this contentious matter. Legalizing physician-assisted suicide and/or euthanasia is opposed by most professional organizations including the American Medical Association.
Dr. Tan is emeritus professor of medicine at the University of Hawaii and director of the St. Francis International Center for Healthcare Ethics. This article is meant to be educational and does not constitute medical, ethical or legal advice. It is adapted from the author’s book, "Medical Malpractice: Understanding the Law, Managing the Risk" (2006). For additional information, readers may contact the author a