The Wish to Die
transient wishes are common among terminally ill patients
Tired of Accute Medical Treatment
change to helping to treat the symptoms and allow the patient to die at home with family
Unrecognized or Undertreatd Physical Symptoms
use analgesics well and thuroughly--do not fear addiction or hastening death
Emergent Psychosocial Problems
not wanting to be a burden
get it out in the open and discuss it
Spritual Crisis
talk with them--help them find medically expereienced clergy
Clinical Depression
do they understand their disease, prognosis, and treatment?
can their depression be treated sucessfully within these limits?
Unrelenting, Intorlerable Suffering
"the patient msut, of his or her own free will and at his or her own initiative, clearly and repeatedly request to die rather than continue suffering"
"the patient’s judgement must not be distorted"
"the patient must have a condition tha tis incurable and associate with severe, unrelenting, intolerable suffering"
"the physician must ensure that the patient’s suffering and the request are not the result fo inadequate comfort care"
"physican assisted suicide shoud only be carried out in the context of a meaningful doctor-patient relationship"
"consultation with another physician who is experienced in comfort care is requierd"
:clear documentatio to suppor teach conditioned above shoudllbe requiered"
The Request for Help in Dying
physicians have to help the patients along both medically and emotionaly
What do Dying Persons Want Most from their Physicians
reatian their physical and personal integrity
Listen and Learn from the Patient Before Responding
Be Compassionate, Caring, and Creative
Promise to Be There Until the End
If Asked, Be Honest About YOur Openness to the Possibility of Assisted Suicide
possibility often more important than the reality
Try to Approach Intolerable End-of-life Suffering With an Open Heart and an Open Mind
Do Not Forget Your Own support