End-of-Life Issues

As the range of options for extending life and for hastening death continues to expand, so the range of issues faced by clinical evaluators also has grown. Among the most complex are those surrounding requests for assisted suicide, euthanasia, or the withdrawal or refusal of life-sustaining interventions. The availability of some of these alternatives varies by jurisdiction and medical condition, although all persons are afforded the right to refuse life-sustaining treatment. However, like all treatment decisions, requests to hasten death depend on the patient's decision-making competence. Forensic evaluators have increasingly been asked to participate in competency evaluations, particularly around end-of-life treatment decisions. For the patient who is incompetent to make treatment decisions, advance directives can help determine the course of end-of-life treatment and help preserve ...