A Call for a Patient-Centered Response to Legalized Assisted Dying
Bibliographic record
Abstract
Ideas and Opinions15 November 2016A Call for a Patient-Centered Response to Legalized Assisted DyingJohn Frye, MA and Stuart J. Youngner, MDJohn Frye, MAFrom the Department of Bioethics, Case Western Reserve University, Cleveland, Ohio. and Stuart J. Youngner, MDFrom the Department of Bioethics, Case Western Reserve University, Cleveland, Ohio.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1319 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail On 9 June 2016, California became the fifth state to legalize physician-assisted suicide (PAS), joining Oregon, Washington, Montana, and Vermont. More states may soon follow. Like it or not, PAS is here and is not going away. Given this reality, it is problematic that professional organizations have left physicians without sufficient support and guidance on how to provide the best possible care to dying patients seeking to exercise this legal right.The refusal of professional organizations—including the American College of Physicians, American Medical Association, and American Osteopathic Association—to provide clinical guidance on the care of patients actively seeking assistance in ...References1. Quill TE, Cassel CK. Professional organizations' position statements on physician-assisted suicide: a case for studied neutrality. Ann Intern Med. 2003;138:208-11. [PMID: 12558360] LinkGoogle Scholar2. Dobscha SK, Heintz RT, Press N, Ganzini L. Oregon physicians' responses to requests for assisted suicide: a qualitative study. J Palliat Med. 2004;7:451-61. [PMID: 15265355] CrossrefMedlineGoogle Scholar3. Campbell CS, Cox JC. Hospice and physician-assisted death: collaboration, compliance, and complicity. Hastings Cent Rep. 2010;40:26-35. [PMID: 20964161] CrossrefMedlineGoogle Scholar4. Hendin H, Rutenfrans C, Zylicz Z. Physician-assisted suicide and euthanasia in the Netherlands. Lessons from the Dutch. JAMA. 1997;277:1720-2. [PMID: 9169901] CrossrefMedlineGoogle Scholar5. Canadian Medical Association. Principles-based recommendations for a Canadian approach to assisted dying. 2015. Accessed at www.cma.ca/Assets/assets-library/document/en/advocacy/cma-framework_assisted-dying_approved-by-board_oct2015.pdf on 11 August 2016. Google Scholar6. Canadian Medical Association. A Canadian approach to assisted dying: a CMA member dialogue summary report. 2015. Accessed at www.cma.ca/Assets/assets-library/document/en/advocacy/Canadian-Approach-Assisted-Dying-e.pdf on 11 August 2016. Google Scholar Author, Article, and Disclosure InformationAffiliations: From the Department of Bioethics, Case Western Reserve University, Cleveland, Ohio.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1319.Corresponding Author: Stuart J. Youngner, MD, Department of Bioethics, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106-4976; e-mail, [email protected]edu.Current Author Addresses: Mr. Frye: Department of Bioethics, Case Western Reserve University School of Medicine, TA 200, 10900 Euclid Avenue, Cleveland, OH 44106-4976.Dr. Youngner: Department of Bioethics, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106-4976.Author Contributions: Conception and design: J. Frye, S.J. Youngner.Drafting of the article: J. Frye, S.J. Youngner.Critical revision of the article for important intellectual content: J. Frye, S.J. Youngner.Final approval of the article: J. Frye, S.J. Youngner.Administrative, technical, or logistic support: S.J. Youngner.This article was published at www.annals.org on 27 September 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Annals of Medical Assistance in Dying Catherine Frazee and Harvey Max Chochinov Metrics Cited byAGS Survey Actually Supports Engaged Neutrality for Physician‐Assisted DeathPoverty: Not a Justification for Banning Physician-Assisted DeathPhysician-Assisted Suicide: Why Neutrality by Organized Medicine Is Neither Neutral Nor AppropriateThe pharmacist and medical aid in dying 15 November 2016Volume 165, Issue 10Page: 733-734KeywordsBioethicsPalliative carePatient advocacyPatientsPeriodic acid SchiffPharmacistsPopulation statisticsPrevention, policy, and public healthSuicideTraditional medicine ePublished: 27 September 2016 Issue Published: 15 November 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.067 | 0.132 |
| Meta-epidemiology (narrow) | 0.001 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.004 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.016 | 0.017 |
| Scholarly communication | 0.020 | 0.022 |
| Open science | 0.006 | 0.028 |
| Research integrity | 0.070 | 0.106 |
| Insufficient payload (model declined to judge) | 0.042 | 0.019 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".