Attitudes of Consultation-Liaison Psychiatrists Toward Physician-Assisted Death Practices LAURA WEISS ROBERTS, M.D., PHILIP R. MUSKIN, M.D. TEDDY D. WARNER, PH.D., TERESITA MCCARTY, M.D. BRIAN B. ROBERTS, M.D., DONALD C. FIDLER, M.D. The objective of this study was to investigate the views of consultation-liaison (C-L) psy- chiatrists on assisted-death practices. A 33-question anonymous survey was distributed at the Academy of Psychosomatic Medicine Annual Meeting in November 1995. The in- strument explored perceptions of acceptability of assisted death in six hypothetical pa- tient situations as performed by four possible agents. The response rate was 48% (184 conference attendees participated, i.e., completed and returned the surveys). With little variability, the respondents were unwilling to perform assisted death personally and also did not support assisted death as performed by nonphysicians. The respondents were somewhat more accepting of referral or other physicians' involvement in such practices. Assisted death was viewed differently than withdrawal of life support. Several variables were analyzed for their influences on the views expressed. The CoL psychiatrists in this study expressed opposition to assisted death practices. Their views varied somewhat de- pending on the the patient vignette and the agent of death assistance. The authors con- clude that CoL psychiatrists may wish to develop their present therapeutic and evaluative role in patient care to alleviate suffering, without hastening patient death. (Psychosomatics 1997; 38:459-471) C onsultation-liaison (C-L) psychiatrists play an invaluable therapeutic and evaluative role in the care of dying patients. By bringing hope to tragic situations, clarifying patients' de- cisional abilities and wishes, assessing the con- tribution of psychiatric symptoms to the medical presentation. addressing the despair of families and companions, and improving pain manage- ment strategies, CoL psychiatrists help to dimin- ish the suffering of the terminally ill. CoL psychiatrists also assist their colleagues to cope with ultimate human experiences by developing collaborative approaches for caring for patients with cancer. AIDS, organ failure, and physical trauma. For these reasons, it is both striking and curious that psychiatrists have been relatively VOLUME 38. NUMBER 5. SEPTEMBER-OCTOBER 1997 silent in the growing discussion of physician- assisted death and euthanasia. I Physician-assisted death is defined as the Received June 24. 1996; revised September 6. 1996; accepted October 18. 1996. From the Department of Psychi- atty, University of New Mexico School of Medicine. Albu- querque; the Department of Consultation-Liaison Psychiatty. Columbia-Presbyterian Medical Center. New York; the Con- sultation Psychiatty Service. University Hospilal. Albuquer- que. New Mexico; the Inpatient Psychiatty Department. Veterans' Administration Medical Center. Albuquerque. New Mexico; and the Consultation-Liaison Psychiatty Department. West Vrrginia University. Morgantown. West Vrrginia Ad- dress reprint requests to Dr. L. Roberts. the University of New Mexico School of Medicine. Department of Psychiatty. 2400 Tucker NE. Albuquerque. NM 87131-5326. Copyright © 1997 Academy of Psychosomatic Med- icine. 459