Physician-assisted suicide: epistemological problems

In the debate over physician-assisted suicide, it is assumed that issues of who might appropriately be granted such extreme assistance or how such decisions might be made can be unambiguously decided. However, the validity of such judgments remains unknown. It is clear that some rate of error in diagnosis and clinical assessment is unavoidable, while there are presently no scientific grounds to believe that competency to request physician-assisted suicide can be reliably determined. At best, resolving the question of when or if to assist a patient in suicide would require a number of clinical judgments which are currently unsupported by any research. Moreover, these judgments are not clearly separable from the physician's feelings towards the procedure, the patient or the patient's family, thus potentially subverting the objectivity needed for such a decision. Even if physician-assisted suicide could be justified on purely ethical grounds, there is no reason to believe that it is possible for physicians accurately to determine whose requests should be granted according to any proposed standards of fitness.