Letter re: Physician-assisted death in chronic neurologic diseases.

Abstract

I read with interest the editorial by Drs. Bernat and McQuillen1 on physician-assisted death (PAD) in chronic neurologic disease. I fully support their view that “physicians have a concurrent duty to respect our patients' liberty-based right to determine themselves what constitutes their best outcome.” However, it is important to remember that, among legislative criteria granting the right to practice PAD, there are 4 requirements: requests must be voluntary, persistent, well-thought, and well-informed.2 Also, and perhaps more importantly, I do not agree that in the Netherlands and Belgium “voluntary active euthanasia now far surpasses PAD in frequency,”1 because, at least in Belgium, assisted suicide is not possible and voluntary active euthanasia is the only legalized PAD (unlike in Canada, Switzerland, and some US states).3