Objective: Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate. Synthesis: We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting. We present areas of common ground and important unresolved differences. Conclusions: We reached differing positions on the first three core ethical questions and achieved unanimity on how critical care clinicians should manage conscientious objections related to physician-assisted suicide and euthanasia. The alternative positions presented in this article may serve to promote open and informed dialogue within the critical care community.

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doi.org/10.1097/CCM.0000000000001818, hdl.handle.net/1765/95564
Critical Care Medicine
Department of Intensive Care

Goligher, E.C. (Ewan C.), Ely, E. W., Sulmasy, D.P. (Daniel P.), Bakker, J., Raphael, J. (John), Volandes, A.E. (Angelo E.), … Downar, J. (2017). Physician-assisted suicide and euthanasia in the ICU: A dialogue on core ethical issues. Critical Care Medicine, 45(2), 149–155. doi:10.1097/CCM.0000000000001818