Physician-Assisted Suicide Guidelines

The American College of Medical Quality (ACMQ) has published guidelines for physicians confronted with a patient’s request for physician-assisted suicide. The guidelines stress the importance of doctors and hospitals having strong safeguards in place for patients and physicians who make the difficult decision to take advantage of the option, where it is legal.

ACMQ, formerly the American College of Utilization Review Physicians and a specialty society recognized by the American Medical Association, strongly advocates that physicians follow the AMA’s policy against taking an active role in a patient’s suicide. However, when a state passes legislation allowing the option of physician-assisted suicide, ACMQ’s guidelines are intended to provide physicians and patients with effective safeguards.

The new guidelines include a mandatory examination by a psychiatrist for evaluation of mental and emotional status, a mandatory waiting period between at least two written requests by the patient, and multidisciplinary consultation to ensure that all appropriate interventions have been exhausted in treating the patient’s illness.

In addition, the guidelines call for the physician to have received “appropriate education, training, and experience to inform the patient about life-terminating alternatives.”

Finally, the new guidelines require mandatory review of each patient’s request by a facility’s bioethics committee to ensure that all criteria have been met before granting its approval to a patient’s request for physician-assisted suicide.

To date, only the state of Oregon has enacted assisted-suicide legislation. Under the three-year-old law, 16 people died in 1998, 27 in 1999, and 11 through the first nine months of 2000. Among those 11 who took advantage of the law in the first three quarters of 2000, 10 had end-stage cancer, and the 11th had amyotrophic lateral sclerosis.

The ACMQ guidelines are accessible on the Web at www.acmq.org/profess/policy27.html.