The role of guidelines in the practice of physician-assisted suicide

Oregon has legalized and implemented physician-assisted suicide, while obse rvers argue about the moral import of attempting to formulate guidelines; t he utility any set of guidelines can have for physician practice, health ca re providers, patients, or families; and whether guidelines can really prot ect against harm or abuse. What were once theoretical questions have taken on new urgency. The debate over the value and power of guidelines includes the following qu estions: What has been the experience of efforts to implement physician-ass isted suicide using consensus guidelines? What goals are guidelines intende d to serve? Who should formulate guidelines? What features should be reflec ted in any proposed guidelines to make them practical and to permit achieve ment of their goals? Are there any fundamental obstacles to the creation or implementation of guidelines', Is dying a process that is amenable to dire ction under guidelines, be they issued by physicians, departments of health , blue ribbon panels, or other regulatory bodies? This paper explores these questions as physician-assisted suicide becomes legal.