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Neurologists support a patient's right to refuse life-sustaining treatment, but many believe that they are killing their patients in supporting such refusals. Thirty-seven percent think it is illegal to administer analgesics in doses that r isk respiratory depression to the point of death. Forty percent believe they should obtain legal counsel when considering stopping life-sustaining treatment. One half believe that PAS should be made explicitly legal by statute for terminally ill patient s. Under current law, 13% would participate in PAS and 4% would carry out VE; if those procedures were legalized, 44% would participate in PAS and 28% in VE. Approximately one third believe that physicians have the same ethical duty to honor a terminall y ill patient's request for PAS as they do to honor a such a patient's refusal of life-sustaining therapy. There is a gap between established medical, legal, and ethical guidelines for the care of dying patients and the beliefs and practices of many neur ologists, suggesting a need for graduate and postgraduate education programs in the principles and practices of palliative care medicine. Many neurologist would participate and carry out VE if legalized. |
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