Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Is it time for a suicide certificate?

James C. Salwitz, MD
Physician
December 30, 2014
Share
Tweet
Share

Physician–assisted suicide: the collaboration of two through a professional relationship, to cause the death of one.

Ever since Socrates took hemlock, suicide has been part of society, sometimes supported, often condemned.  Today, many argue that we have a right to die, sort of an infinite extension of free speech or thought.   Regardless, to actively involve doctors is a unique distortion of the medical arts, as if stopping a beating heart can somehow mend disease.  For a healer to take life is bizarre and threatens the physician-patient relationship.  If individuals really want and require assistance to die perhaps there is another solution.

A long trail of vital documents marks our lives. These include birth certificate, diplomas, driver’s and marriage license, advanced directives, wills and most recently the POLST. Perhaps we should create a new personal document.  Its purpose would be to give each person not only permission to kill themselves, but access to the means.  A permit controlled by the patient and only their responsibility.  A passport for dying.  A suicide certificate.

The suicide certificate would be a kind of application.  A legal checklist, which once complete would allow the individual to die by their own hand, but in a controlled and definite manner.

What would go on this form?  First, basic demographics: name, birth-date, address, social security number, etc.  It is important to confirm that the right person is filling out the form.  A photograph might be a good idea.

Next, statements regarding right-to-die laws.  This could include a review of the sanctioned methods available, as well as the legal indications and limits for committing suicide.  It might remind the applicant that a terminal disease is required, what is and is not a qualifying medical condition, and that suicide pacts are discouraged and therefore forbids sharing the lethal prescription. The whole form might start online and as part of the process an instructional video must be viewed and review answers given correctly, before it can be printed.  Alternatively, an app could be developed.

If the state requires terminal disease for suicide, the form should have a place for a doctor to confirm that the patient is dying.  Two signatures from the physician would be required, on two dates at least two weeks apart.  Either the specific disease must be entered or, to protect privacy, a general statement of imminent natural death.  This means that while the doctor is involved in the application process, his/her role is not to prescribe the means to cause death, but rather confirm the presence of disease.

There might be a counseling section, which would require that the patient speak with a psychologist, social worker or clergy.  As an alternative a signature from a healthcare provider, other than the primary treating doctor, which affirms that the patient is not psychiatrically ill and understands their actions.

Finally, a list of organizational reminders to help with final plans.  “Is your will complete?” “Have you emptied your safe deposit box?” “Does your family know your plans and do they have copies of your important papers?” “Have you completed funeral arrangements?”   “Have you determined who will discover and/or handle your body?” “Have you said goodbye?”

Once the form was complete, itemized and notarized, the patient would take it to a suicide-assistance-registered pharmacy or perhaps a specialty funeral home, which would exchange this ultimate document for death-inducing-drugs.  The sealed suicide kit would come with a final instructional booklet, including safety warnings.

While this idea is bureaucratic and strange, it does achieve two goals.  First, it removes doctors, healers, from the direct ordering of death.  The final signature at the bottom of the form — the “order” for the drugs — is the patient’s.  The second is that it empowers those who believe in suicide a legal outlet, as well as the tools to act.   If there is a freedom to die, then the responsibility must be each of ours, alone.

James C. Salwitz is an oncologist who blogs at Sunrise Rounds.

Prev

How the kind, humble physician met his demise

December 30, 2014 Kevin 16
…
Next

KevinMD's most popular posts of 2014

December 31, 2014 Kevin 4
…

ADVERTISEMENT

Tagged as: Palliative Care

Post navigation

< Previous Post
How the kind, humble physician met his demise
Next Post >
KevinMD's most popular posts of 2014

ADVERTISEMENT

More by James C. Salwitz, MD

  • Each line on the radiology list is a patient’s line in the sand

    James C. Salwitz, MD
  • The broader mission for hospice care

    James C. Salwitz, MD
  • Is the medical profession at its end?

    James C. Salwitz, MD

More in Physician

  • Why so many doctors secretly feel like imposters

    Ryan Nadelson, MD
  • Why enterprise risk management is key to value-based health care success

    Olumuyiwa Bamgbade, MD
  • Rethinking physician resilience for sustainable well-being

    Sarah Webber, MD
  • How shared language saved a patient from isolation

    Syed Ahmad Moosa, MD
  • The shocking risk every smart student faces when applying to medical school

    Curtis G. Graham, MD
  • The physician who turned burnout into a mission for change

    Jessie Mahoney, MD
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why so many doctors secretly feel like imposters

      Ryan Nadelson, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Why hospital jobs are failing physicians: burnout, pay, and lost autonomy

      Justin Nabity, CFP | Finance
    • Why so many doctors secretly feel like imposters

      Ryan Nadelson, MD | Physician
    • Why telling kids to eat less and move more fails to address obesity

      Callia Georgoulis | Conditions
    • Why enterprise risk management is key to value-based health care success

      Olumuyiwa Bamgbade, MD | Physician
    • Rethinking physician resilience for sustainable well-being

      Sarah Webber, MD | Physician
    • How shared language saved a patient from isolation

      Syed Ahmad Moosa, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 21 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why so many doctors secretly feel like imposters

      Ryan Nadelson, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Why hospital jobs are failing physicians: burnout, pay, and lost autonomy

      Justin Nabity, CFP | Finance
    • Why so many doctors secretly feel like imposters

      Ryan Nadelson, MD | Physician
    • Why telling kids to eat less and move more fails to address obesity

      Callia Georgoulis | Conditions
    • Why enterprise risk management is key to value-based health care success

      Olumuyiwa Bamgbade, MD | Physician
    • Rethinking physician resilience for sustainable well-being

      Sarah Webber, MD | Physician
    • How shared language saved a patient from isolation

      Syed Ahmad Moosa, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Is it time for a suicide certificate?
21 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...