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Frye and Youngner note that professional organizations have based their opposition to physician-assisted suicide on such concerns as possible reductions in the quality of end-of-life care; potential encouragement or coercion by family members and others of individuals to seek death, especially among the poor, uneducated, uninsured, and disabled; and a slippery slope to non-voluntary euthanasia. But, the authors say, these possibilities constitute the very reason that constructive engagement by organized medicine is essential. Formal opposition and studied neutrality, they write, provide little assistance to health care professionals who must decide how best to respond to their patients requests and to reduce harm from abuse. This puts the entire burden on individual physicians to struggle in isolation in responding to such patient requests. The authors write that their concerns are not simply theoretical. They note that primary physicians facing requests to help patients commit suicide in Oregon reported feeling frustrated by not being able or willing to communicate with others in their practices and profession, given the polarizing nature of the issue. https://www.youtube.com/watch?feature=youtu.be&v=Pf7JuJcVzQUThis is problematic because under state laws allowing physician-assisted suicide, primary physicians must identify a consulting physician to confirm the prognosis and decision-making capacity of the patient. Organized medicine is missing important opportunities, Frye and Youngner say. First is the chance to educate primary care physicians in how to choose a second-opinion consultant. Second is the opportunity to train physicians to better support these patients and their families as well as recognize factors such as treatable depression, which may be contributing to the desire to commit suicide. Moreover, studied neutrality can have negative consequences for patients. A study concluded that most Oregon hospice policies were consistent with studied neutrality.
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