Palliative Care against Medically Assisted Death? Misunderstanding and Instrumental Objections

Am J Hosp Palliat Care. 2023 Aug 22:10499091231196302. doi: 10.1177/10499091231196302. Online ahead of print.

Abstract

Context: Palliative Care (PC) and Medically Assisted Death (MAD), specifically assisted suicide and euthanasia, are distinct practices characterized by differing objectives, methods, implementation and outcomes. Representatives of PC, including scientific societies or physicians, may, in certain cases, adopt a critical stance towards MAD.

Objectives: The study aims to explore the underlying reasons for such opposition.

Methods: To this end, the philosophical underpinnings and legal conditions of PC and MAD will be analyzed.

Results: The ethical and philosophical landscape of PC and MAD leads us to identify, on one hand, the Hippocratic paradigm and, on the other hand, what we call Socratic medicine. From a legal analysis perspective, the presence of intolerable suffering serves as a common ground between the two practices, albeit risking being the subject of misunderstandings and instrumental objections.

Conclusion: Preventing an instrumental use of PC in relation to MAD is crucial to enable the respect and the coexistence of the two practices.

Keywords: assisted suicide; bioethics; euthanasia; medical ethics; medically assisted death; palliative care.