The passage of the Oregon Death With Dignity Act has profound implicat
ions for the prevailing model of care for dying patients. Patients are
already asking for assisted suicide, Most physicians have not been tr
ained in evaluating these requests in a therapeutic way, We discuss th
e issues around the needs of dying patients and, regardless of the leg
al status, what to do when patients ask for a lethal dose of medicatio
n, With the tools to explore the meaning of these requests, physicians
will be better able to understand and meet the needs of their dying p
atients.