In the United States, patients frequently die under the care of strangers in an impersonal hospital setting, surrounded by noisy machines. This is a far cry from the comfort of a patient’s home where they are surrounded by loved ones. Medical-assisted death, however, provides an alternative for patients seeking to avoid prolonged suffering in a hospital setting. Methods of medical-assisted death include self-ingested or physician-assisted lethal medication.

According to a 2021 SAG Open Medicine article, the goals of palliative care include alleviating suffering, providing the best possible QOL, and optimizing comfort in death. Authors of the article suggest that patients who lose the ability to communicate a desire to end treatments would benefit from advance directives. Advance directives are legal documents that detail the type of care a patient desires, should the patient fall victim to serious injury or neurodegenerative disease. They are particularly helpful for patients experiencing extreme suffering. Patients must be at least 18 to be eligible.

Physicians Must Consider Patients’ Religious & Cultural Beliefs

Advance directives might contain items like a living will, do not resuscitate order (DNR), durable power of attorney for healthcare (DPA), or physician orders for life-sustaining treatment (POLST). Living wills state patient-preferred medical or life-sustaining treatments for those who become permanently unconscious or terminally ill.

Patients who opt for DNRs are officially informing hospital staff to refrain from performing cardiopulmonary resuscitation (CPR) should the patient suffer from heart failure or cessation of breath. DNRs can be both included in or separate from a living will. A DPA serves useful in identifying the party responsible for a patient’s healthcare decisions, should they be unable to independently make them. For patients with grave illnesses, POLSTs ensure that they receive desired care.

When considering end-of-life care, physicians must also consider a patient’s cultural and religious beliefs, as this improves their mental health and daily existence. According to a 2021 StatPearls article, faith helps patients to mitigate health-related anxiety. For example, some religions prohibit euthanasia. Likewise, physicians may elect to refuse providing certain elements of standardized care that may conflict with their religious or cultural beliefs.

Medical-Assisted Death Is Currently Legal in 10 States

For example, some Catholic physicians may refuse to perform abortions or sterilizations. It’s important to note, however, that such physicians may face tort liability, should their patients be harmed by medical inaction. Therefore, physicians with cultural or religious-based beliefs that conflict with certain medical treatments are best advised to be transparent with patients, thereby providing the opportunity for patients to seek desired care elsewhere.

Medical-assisted death is currently legal in 10 states. Physicians assisting a patient’s right-to-die options benefit from taking their cues from principles of universal ethics. According to SAGE Open Medicine, the principles of universal ethics include autonomy, beneficence, nonmaleficence, fidelity, and justice. Doing so ensures quality care that holistically considers a patient’s needs and desires.


For more on the topic, check out or Physician Editor-in-Chief’s take on Death With Dignity.