“Even if it’s becoming increasingly understood and somewhat more accepted by physicians, the public is significantly ahead in their support of this practice than physicians,” Dr. Derse said in an interview. “Physicians tend to be more wary and the reasons why have to do with, in part, the availability of palliative care, other alternatives, and concerns about the prohibition by the Hippocratic oath of giving patients something that would cause their death.”
The potential for abuse and overuse of physician-assisted suicide also remain a top concern. Such considerations were addressed in two studies and a commentary published in the Aug. 10 online issue of JAMA Internal Medicine. One study analyzed physician-assisted suicide and euthanasia cases at a Netherlands End-of-Life Clinic. The other reviewed the euthanasia rate in Belgium. Authors of the Netherlands study found that of 645 death requests made from 2012 to 2013, 25% were granted, 47% were refused, 9% withdrew their requests, and 19% died before their request were assessed. Notably, 7% of those approved for euthanasia or physician-assisted suicide were categorized as “tired of living.” Nearly 4% reported only psychological suffering. The Belgium study meanwhile, found the rate of euthanasia has increased from 1.9% of all deaths in Flanders, Belgium, in 2007, to 4.6% of all deaths in 2013.
“Both studies report worrisome findings that seem to validate concerns about where these practices might lead,” Dr. Caplan wrote in an associated commentary. “These findings, and other recent data regarding the speeding of patients’ deaths, make this a key moment to revisit efforts in the legalization of assisted dying in the United States and elsewhere, and, specifically, the role of the medical profession.”
U.S. doctors are also closely watching how the practice of assisted suicide unfolds in Canada. In striking down a federal law against physician-assisted suicide in February, the Supreme Court of Canada set a deadline of Feb. 6, 2016, for policies regarding the practice to be in place.
Dr. Derse said Canada’s use of the practice may present some good lessons for Americans, but will likely have a limited affect on the United States.
Dr. Caplan however, believes the legalization of physician-assisted suicide in Canada will have a big impact on the United States.
It’s “close by [and a] similar country,” he said. “We’ll be watching to see how they implement it.”
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