The Supreme Court addresses physician-assisted suicide - Can its rulings improve palliative care?

In June 1997, the US Supreme Court unanimously decided:that competent, term inally ill patients have no general constitutional right to commit suicide or to obtain assistance in committing suicide. Thus, the broad prohibitions against any kind of suicide assistance that almost every state has enacted do not violate the constitution. While many of the rulings and the bulk of the reaction to them focused on the Supreme Court's resolution of importan t legal controversies-regarding: physician-assisted suicide, this article;f ocuses on the resulting potential for change in physicians' opinions on pal liative care. The Court's reasoning may help physicians resolve substantial ethical dilemmas regarding the provision of narcotics given in high dosage s, the care of incompetent patients, and the suffering caused by symptoms o ther than pain. For example,the,Court concluded that a physician's intent c an distinguish permissible acts of aggressive pain relief from impermissibl e acts of hastening death. This distinction has clinical uses and can help physicians develop ethical guidelines and practice standards to improve pal liative care near the end of life.