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  • Introduction
  • 1. Advance Care Planning
  • 2. Communicating Bad News
  • 3. Whole Patient Assessment
  • 4. Pain Management
  • 5. Assisted Suicide Debate
  • 6. Anxiety, Delirium
  • 7. Goals of Care
  • 8. Sudden Illness
  • 9. Medical Futility
  • 10. Common Symptoms
  • 11. Withholding Treatment
  • 12. Last Hours of Living
  • 13. Cultural Issues
  • 14. Religion, Spirituality
  • 15. Legal Issues
  • 16. Social and Psychological
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    Legal Issues

    Physician Assisted Suicide: A Matter of State Law
    • Perhaps no other end-of-life ethical issue has generated as much controversy as physician-assisted suicide
    • Ethical and legal consensus that patient refusal of life-sustaining medical treatment is not suicide
    • However, provision of medication with intent to produce death is considered to be assisting suicide
    • All states except Oregon have laws that make assisting a suicide by anyone (including physicians) a criminal offense
    • Recently, some patients and physicians have argued that suicide with the assistance of a physician should be available for
      • Patients who have advanced life-threatening illnesses
      • Who have decision-making capacity
    • In 1997, United States Supreme Court held that there is no federal Constitutional right to assisted suicide
      • In doing so, it reaffirmed the distinction between

        • Withholding or withdrawing life-sustaining treatment
        • Versus assisted suicide

      • Decision leaves open the possibility that state supreme courts will find a state constitutional right, or, more likely, that states will develop a statutory right

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