Medical experts in the United States remain divided in their opinion of whether physician-assisted suicide should be legal, a new poll suggests, indicating that the way in which patients die and the role of palliative care will remain issues of much debate.
In the poll conducted by the New England Journal of Medicine (NEJM) among the journal's readers, who are primarily health-care providers, people from 74 countries cast 2,356 votes, including 1,712 votes from U.S. readers.
Overall, about 65 percent of votes were against the idea of permitting physician-assisted suicide. The rate among U.S. voters was similar, with about 67 percent voting against physician-assisted suicide.
In physician-assisted suicide, doctors provide terminally ill patients with the means to end their own life – for example, giving them a prescription for a lethal dose of medicine, which the patient can later decide whether to take.
Proponents of physician-assisted suicide say that people, in face of an inevitable death, deserve the right to end their lives on their own terms, without pain and suffering. [Top 10 Leading Causes of Death]
Opponents say that physicians taking a role in a patient's suicide violates a fundamental tenet of medicine by contradicting the doctor's role as a healer.
Oregon was the first state to legalize physician-assisted suicide, with the passing of the Death with Dignity Act in 1997. Two other states, Washington and Vermont, followed suit.
In the poll, the readers were presented with the case of a 72-year-old man in Oregon who was receiving palliative care for incurable metastatic pancreatic cancer, and was contemplating physician-assisted suicide.
In only 11 of the 74 countries from which votes were cast did a majority vote in favor of permitting physician-assisted suicide. The number of votes from those countries was relatively small, with a total of 97 votes coming from those 11 countries. The largest number of these votes, 37, was cast by readers from Mexico, according to the poll results published today (Sept. 11) in the NEJM.
In 18 U.S. states, a majority of votes supported physician-assisted suicide. Interestingly, the researchers said, Oregon and Washington were not in that group.
The researchers caution, however, that such online voting is prone to bias and may not be scientifically valid. Also, the number of votes in some countries was too low to draw any conclusions, said Dr. Jonathan Adler, physician at the Massachusetts General Hospital and an editor at the NEJM who conducted the poll.
More than 200 comments were posted in the poll, in which readers made arguments to support their beliefs.
Readers opposed to physician-assisted suicide questioned whether suicide was a civil right or a human right, and expressed the belief that assisting suicide violated a physician’s oath to do no harm.
Some opponents worried that physician-assisted suicide could eventually lead to physician-assisted euthanasia, in which a doctor would take an active role in the patient’s death — for example, by administering a lethal drug rather than just prescribing it.
Proponents of physician-assisted suicide highlighted the importance of honoring patients’ autonomy and noted that if physicians assist at birth, they should also have a role in assisting at death, the researchers said.
Many commentators on both sides of the divide agreed that palliative care, including hospice, are important for helping terminally ill patients manage their pain and suffering, both physical and psychological, the researchers said.
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