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  • Print publication year: 2010
  • Online publication date: March 2012

32 - The ethics of research on pain and other symptoms for which effective treatments already exist

from 4 - Research and publication


This chapter presents a case study which analyzes whether physicians can end a patient's life at his or her request (as in euthanasia), or otherwise collaborate with the ending of life at a patient's initiative (as in assisted suicide). A request for euthanasia or assisted suicide is an emotionally taxing situation, where a thoughtful and respectful response is particularly important. Requirements for legal euthanasia or assisted suicide include that patients need to be capable of decision making and persistently requesting death, and that there be otherwise intractable suffering. Requests for aid-in-dying should be taken seriously and carefully listened to. Screening for and treatment of problematic symptoms and depression may lead to withdrawal of the request. When a request for aid-in-dying persists and no life-sustaining treatments are being employed, the response will depend on the legal status of euthanasia or assisted suicide, and on the physician's own convictions.

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Further reading

CIOMS (2002). Guideline 4: Individual Informed Consent. International Ethical Guidelines for Biomedical Research Involving Human Subjects. Geneva: CIOMS.
Emanuel, E. J., Grady, C., Crouch, R. A., et al. (2008). The Oxford Textbook of Clinical Research Ethics. Oxford, New York: Oxford University Press.
Emanuel, E. J., Wendler, D., and Grady, C. (2000). What makes clinical research ethical?JAMA, 283(20), 2701–11.
Faden, R. and Beauchamp, T. (1986). A History and Theory of Informed Consent. Oxford, New York: Oxford University Press.
Grisso, T. and Appelbaum, P. S. (1998). Assessing Competence to Consent to Treatment. A Guide for Physicians and Other Health Care Professionals. New York: Oxford, Oxford University Press.
Hawkins, J. S. and Emanuel, E. J. (2005). Clarifying confusions about coercion. Hastings Cent Rep 35(5), 16–19.
International Association for the Study of Pain. Ethical Guidelines for Pain Research in Humans.