The challenge for future debate on euthanasia

There is a significant pattern emerging in the discourse about euthanasia and assisted suicide as exemplified in the other articles in this special issue of the Journal of Pain and Symptom Management. That pattern is a dynamic tension that should be nurtured in the best interests of our options at the end of life. On the one hand, there is general acceptance of the right to self-determination and (within debatable limits) of the rationality and mortality of suicide. And on the other hand, there has been emphasis on comfort care through appropriately chosen medications and through a wholesome doctor-patient relationship that fosters a view of life worth living. Thus the creative tension is between the freedom to be dispatched with a minimum of suffering and the efforts to make it more desirable to stay and fight. It is a variation of the "fight or flight" response. The tension must be maintained for the good of us all. Too much emphasis on either one would skew the balance, and a dangerous extreme could result.