Request for Assisted Suicide

  • Rachel E. Diamond
  • Puneeta Khurana
  • Timothy E. QuillEmail author
Reference work entry


Physician-assisted dying (PAD) is receiving increasing media and academic attention, and legalization is expanding internationally. The potential legitimization of this practice is laden with medical, legal, and ethical considerations. Regardless of legality or willingness to participate, clinicians must be able to respond to enquiries about this topic, whether the patient’s aim is information gathering or a formal request to end his or her life.


  1. Battin MP, van der Heide A, Ganzini L, van der Wal G, Onwuteaka-Philipsen BD. Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in “vulnerable” groups. J Med Ethics. 2007;33(10):591–7.CrossRefGoogle Scholar
  2. Fins JJ, Bacchetta MD. Framing the physician-assisted suicide and voluntary active euthanasia debate: the role of deontology, consequentialism, and clinical pragmatism. J Am Geriatr Soc. 1995;43(5):563–8.CrossRefGoogle Scholar
  3. Fromme EK, Smith MD. Ethical issues in palliative care. UpToDate. Accessed 14 May 2017.Google Scholar
  4. Ganzini L, Goy ER, Dobscha SK. Why Oregon patients request assisted death: family members’ views. J Gen Intern Med. 2007;23(2):154–7.CrossRefGoogle Scholar
  5. Government of Canada website: Medical Assistance in Dying. Accessed 12 May 2017.
  6. Quill TE. Death and dignity. A case of individualized decision making. N Engl J Med. 1991;324:691–4.CrossRefGoogle Scholar
  7. Quill TE, Battin M. Responding to requests for physician-assisted death. UpToDate. Accessed 14 May 2017.Google Scholar
  8. Quill TE, Byock IR. Responding to intractable terminal suffering: the role of terminal sedation and voluntary refusal of food and fluids. ACP-ASIM end-of-life care consensus panel. American College of Physicians-American Society of internal medicine. Ann Intern Med. 2000;132:408–14.CrossRefGoogle Scholar
  9. Quill TE, Dresser R, Brock DW. The rule of double effect – a critique of its role in end-of-life decision making. N Engl J Med. 1997a;337:1768–71.CrossRefGoogle Scholar
  10. Quill TE, Lo B, Brock DW. Palliative options of last resort: a comparison of voluntarily stopping eating and drinking, terminal sedation, physician-assisted suicide, and voluntary active euthanasia. JAMA. 1997b;278:2099–104.CrossRefGoogle Scholar
  11. Quill TE, Back AL, Block SD. Responding to patients requesting physician-assisted death. JAMA. 2016;315(3):245–6.CrossRefGoogle Scholar
  12. Royal Dutch Medical Association (KNMG). Guideline for Palliative Sedation [Internet]. 2009. Available from:
  13. Schildmann EK, Schildman J, Kiesewetter I. Medication and monitoring in palliative sedation therapy: a systematic review and quality assessment of published guidelines. J Pain Symptom Manag. 2015;49(4):734–46.CrossRefGoogle Scholar
  14. Varelius J. The value of autonomy in medical ethics. Med Health Care Philos. 2006;9(3):377–88.CrossRefGoogle Scholar
  15. Victoria becomes first state to legalise assisted dying as parliament passes bill. Accessed 28 Jan 2018.
  16. William D, Fiorini MD. It’s over, Debbie. JAMA. 1988;259:272.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Rachel E. Diamond
    • 1
  • Puneeta Khurana
    • 1
  • Timothy E. Quill
    • 1
    Email author
  1. 1.Palliative Care Division, Department of MedicineUniversity of Rochester Medical CenterRochesterUSA

Personalised recommendations