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PROCEEDINGS OF A WORKSHOP
Rebecca A. English, Catharyn T. Liverman,
Caroline M. Cilio, and Joe Alper, Rapporteurs
Board on Health Sciences Policy
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by The Greenwall Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-47695-9
International Standard Book Number-10: 0-309-47695-X
Digital Object Identifier: https://doi.org/10.17226/25131
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Copyright 2018 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Physician-assisted death: Scanning the landscape: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25131.
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PLANNING COMMITTEE FOR A WORKSHOP ON PHYSICIAN-ASSISTED DEATH: SCANNING THE LANDSCAPE AND POTENTIAL APPROACHES1
JAMES CHILDRESS (Chair), University of Virginia
ANTHONY BACK, University of Washington
NANCY BERLINGER, The Hastings Center
LINDA GANZINI, Oregon Health & Science University
SCOTT HALPERN, University of Pennsylvania
BARBARA JONES, The University of Texas at Austin
JOANNE LYNN, Altarum Institute
DAVID MAGNUS, Stanford University
DAVID ORENTLICHER, University of Nevada, Las Vegas
RICHARD PAYNE, Duke University
JAMES TULSKY, Dana-Farber Cancer Institute
NEIL WENGER, University of California, Los Angeles
Health and Medicine Division Staff
REBECCA A. ENGLISH, Program Officer
CATHARYN T. LIVERMAN, Senior Program Officer
ANNE CLAIBORNE, Senior Program Officer (until February 2018)
CAROLINE M. CILIO, Senior Program Assistant
DANIEL CESNALIS, Financial Associate
ANDREW M. POPE, Director, Board on Health Sciences Policy
Consultant
JOE ALPER, Consulting Writer
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the rapporteurs and the institution.
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Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by HUDA AKIL, University of Michigan, and DONALD STEINWACHS, Johns Hopkins University.
They were responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.
Contents
Organization of the Proceedings
2 CONCEPTUAL, LEGAL, AND ETHICAL CONSIDERATIONS IN PHYSICIAN-ASSISTED DEATH
Concepts and Terms in Physician-Assisted Death
Reflections on the Ethics of Physician-Assisted Death
3 EXPERIENCES WITH AND REFLECTIONS ON PHYSICIAN-ASSISTED DEATH IN THE UNITED STATES
4 EXPERIENCES WITH AND REFLECTIONS ON PHYSICIAN-ASSISTED DEATH INTERNATIONALLY
5 IMPLEMENTATION AND PRACTICE OF PHYSICIAN-ASSISTED DEATH
Reflections on Preparing for and Responding to Legalization in California
Data Collection and Public Reporting
Long-Term Services and Supports
7 REFLECTIONS ON THE WORKSHOP AND EVIDENTIARY GAPS
Session One Reflections: Evidence and Terms of Discussion
Session Two Reflections: Provider Experiences and Approaches
Session Three Reflections: Physician-Assisted Death in the Broader Context
Session Four Reflections: Data Collection in the United States and Other Countries
Research and Further Discussions
B Biographical Sketches of Workshop Speakers and Planning Committee Members
Boxes, Figures, and Tables
BOXES
3-1 Brittany Maynard and Dan Diaz
FIGURES
4-4 Estimates of requests and granted requests from psychiatric patients in the Netherlands
5-1 Potential patient navigator system for physician-assisted death
5-2 Google searches in the United States related to the end of life, 2012–2017
6-2 Primary values of hospice physician-assisted death policies
Acronyms and Abbreviations
ALS | amyotrophic lateral sclerosis |
DSM | Diagnostic and Statistical Manual of Mental Disorders |
EOLOA | California’s End of Life Option Act |
MRI | magnetic resonance imaging |
ODDA | Oregon Death with Dignity Act |
OECD | Organisation for Economic Co-operation and Development |
POLST | Physician Orders for Life-Sustaining Treatment |
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