We applaud CMAJ’s efforts at advancing the discussion on physician-assisted suicide; however, we take exception to several of the points presented in Downey’s commentary.1
First, this issue is not about physicians balking at oversight, it’s about physicians being asked to do something contrary to their current practice. Let’s not turn this into something more convoluted.
Second, Downey states that much may be learned from the experience of others, including palliative care physicians.1 Is the suggestion that palliative care physicians represent the de facto group to advance physician-assisted suicide? Let’s be clear that palliative care physicians have stated that they do not want to be associated with physician-assisted suicide.2 Our focus is to relieve suffering, not to terminate life. Many of our patients already view the palliative care team as the grim reaper service. Adding a clear association with physician-assisted suicide will only exacerbate this.
Third, Downey states that both new and experienced physicians will need to learn how to deliver assisted dying. The number of patients requesting assisted suicide is very small. Do we want to spend considerable time and resources teaching medical students and experienced physicians an “intervention” that the vast majority will never carry out? A group of providers who want to do this will need to be identified and receive appropriate training and regulation.
What is truly needed is better access to palliative care training for both trainees and experienced physicians. Palliative care is given only minimal consideration in current medical school curricula, and yet, the vast majority of physicians will at some point be responsible for the care of patients near the end of life. Let’s put our resources where we can make a meaningful impact for the vast majority of our patients.