Autonomy in Physician-Assisted Suicide

Madam: I am responding to the article by Tania Salem, Physician-Assisted Suicide: Promoting Autonomy-Or Medicalizing Suicide? (HCR, MayJune 1999). Salem notes that 80 percent of deaths in the United States take place in health care facilities, while as recently as only fifty years ago the number was much less. There is no question that that is the case, but in my role as a radiation oncologist, it has become quite clear to me that the vast majority of my patients and their families wouldn't have it any other way. It is extremely difficult for family members to care for a loved one during the dying process, especially if spouses or children work or are caring for families of their own. Patients are frequently relieved, as are family members, when a decision is made to admit the individual, even when that accomplishes very little. When it becomes obvious to all that

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