Three Roles for Clinical Ethicists to Provide Clarity and Guidance on Physician-Assisted Suicide/Euthanasia

A minority of countries around the world have taken steps to legalize the practice of physician-assisted suicide and/or euthanasia (PAS/E). Proponents frame PAS/E as a means to enhance patient autonomy, reduce suffering, alleviate the burden of illness, and respect patient dignity. Critics of PAS/E, on the other hand, assert that it reflects a distortion of autonomy, mistakes the source of patient suffering, and dangerously affirms to people that their dignity and worth are contingent on not requiring burdensome caregiving. This has the potential to create uncertainty for how clinicians and institutions should provide ethical guidance to patients on morally controversial matters such as PAS/E. Although ethicists have a duty to explain the range of ethical arguments, they also have an obligation to reinforce ethical boundaries and provide decisive guidance when an intervention is irreconcilable with the practice of medicine. In their clinical role, ethicists can explain why PAS/E is not a healing act and why it violates the principles of beneficence and nonmaleficence. This article outlines three roles for clinical ethicists to provide education, consultation, and develop policies designed to respond to patient suffering in a manner that preserves the integrity of medicine.