Protecting Physicians Providing Palliative Care Consistent with Patient Wishes Barbara Coombs Lee, P.A., J.D. Dear Editor: News that common palliative treatments often trigger accusations of murder and euthanasia should reverberate throughout the medical community. The authors 1 report that palliation in the process of ventilator withdrawal and the use of opiates for symptom treatment were most likely to elicit investigation for criminal intent and behavior. Physicians delivering excellent care, preventing suffering at life’s end, and acting according to a patient’s wishes, should have clear legal protections. Unfortunately, under current law in most states, legality hinges on the state of mind of the physician, and whether the physician intends the death of the patient, rather than whether the treatment was appropriate for the situation and consistent with the request or consent of the patient or surrogate. The authors call for education to remedy the situation, but this is unlikely to help. Most accusers are not uneducated lay persons, but instead are physicians or healthcare professionals who are likely to object on moral or religious grounds. The only solution is legal protection for medical caregivers consistent with the informed, documented healthcare decisions of the patient or the surrogate. Intent protection will always be vulnerable to accusation and sec- ond-guessing, and will never offer real security to doctors or optimal care to their patients. Reference 1. Goldstein NE, Cohen LM, Arnold RM, Goy E, Arons S, and Ganzini L: Prevalence of formal accusations of murder and euthanasia against physicians. J Palliat Med 2012;15: 334–339. Address correspondence to: Barbara Coombs Lee, P.A., J.D. Compassion & Choices P.O. Box 101810 Denver, CO 80250 E-mail: [email protected] Compassion & Choices, Denver, Colorado. JOURNAL OF PALLIATIVE MEDICINE Volume 15, Number 7, 2012 ª Mary Ann Liebert, Inc. DOI: 10.1089/jpm.2012.0112 736

Protecting Physicians Providing Palliative Care Consistent with Patient Wishes

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Protecting Physicians Providing PalliativeCare Consistent with Patient Wishes

Barbara Coombs Lee, P.A., J.D.

Dear Editor:News that common palliative treatments often trigger ac-

cusations of murder and euthanasia should reverberatethroughout the medical community. The authors1 report thatpalliation in the process of ventilator withdrawal and the useof opiates for symptom treatment were most likely to elicitinvestigation for criminal intent and behavior. Physiciansdelivering excellent care, preventing suffering at life’s end,and acting according to a patient’s wishes, should have clearlegal protections. Unfortunately, under current law in moststates, legality hinges on the state of mind of the physician,and whether the physician intends the death of the patient,rather than whether the treatment was appropriate for thesituation and consistent with the request or consent of thepatient or surrogate. The authors call for education to remedythe situation, but this is unlikely to help. Most accusers arenot uneducated lay persons, but instead are physicians orhealthcare professionals who are likely to object on moral orreligious grounds. The only solution is legal protection for

medical caregivers consistent with the informed, documentedhealthcare decisions of the patient or the surrogate. Intentprotection will always be vulnerable to accusation and sec-ond-guessing, and will never offer real security to doctors oroptimal care to their patients.

Reference

1. Goldstein NE, Cohen LM, Arnold RM, Goy E, Arons S, andGanzini L: Prevalence of formal accusations of murderand euthanasia against physicians. J Palliat Med 2012;15:334–339.

Address correspondence to:Barbara Coombs Lee, P.A., J.D.

Compassion & ChoicesP.O. Box 101810

Denver, CO 80250

E-mail: [email protected]

Compassion & Choices, Denver, Colorado.

JOURNAL OF PALLIATIVE MEDICINEVolume 15, Number 7, 2012ª Mary Ann Liebert, Inc.DOI: 10.1089/jpm.2012.0112

736