Rebecca Brendel, M.D., J.D. Assistant Director, Forensic Fellowship Program, Law & Psychiatry Service, Massachusetts General Hospital
Instructor in Psychiatry, Harvard Medical School

Seminar Topic Physician assisted suicide
      Since the 1990 Cruzan U.S. Supreme Court decisions, lawmakers, clinicians, and ethicists have recognized the broad-ranging autonomy of individuals to make decisions regarding the refusal and withdrawal of life-sustaining treatment.  As the individual rights of dying patients to refuse life-sustaining treatment have become ethically, politically, and culturally accepted to patients and doctors alike, inevitable questions emerged about the scope of patients’ autonomy interests at the end-of-life.  Specifically, as broad principles of autonomy supported withdrawal of treatment and non-intervention, ethical questions emerged regarding the scope and limits of individuals’ rights to determine the time, place, and manner of their deaths.
      Less then a decade after Cruzan, Oregon became the only United States jurisdiction to legalize physician-assisted suicide.  Initiatives to permit physician-assisted suicide are presently underway in other states.  These legal developments are signals that, as suggested by the Supreme Court in its 1997 Washington v. Glucksberg decision regarding physician-assisted suicide, that a national debate is underway regarding how our nation will address critical topics regarding care and the limits on patient autonomy at the end of life.  Now, with a decade of data about physician-assisted suicide, we are in a unique position to embark on a theoretical, as well as practical, exploration of the ethical dimensions of end-of-life care.
      This session will explore the ethical dimensions of end-of-life care, with particular attention to the challenges posed by physician assisted suicide and euthanasia.  In particular, what are the moral considerations that favor the expansion of individual autonomy interests at the end of life, and what principles would lead us to exercise caution or restraint on these autonomy interests.  We will also explore the ethical implications of varying degrees of physician involvement in end-of-life care and death for health care and the medical profession.  During this session, we will engage and question often cited distinctions between causing death and letting die, hastening death and double effect, and entitlement and fiduciary responsibility.

To learn more about Dr. Rebecca Brendel click here.
http://www.massgeneral.org/allpsych/Law/brendel.asp