Abstract
Dear Editor:
News that common palliative treatments often trigger accusations of murder and euthanasia should reverberate throughout the medical community. The authors 1 report that palliation in the process of ventilator withdrawal and the use of opiates for symptom treatment were most likely to elicit investigation for criminal intent and behavior. Physicians delivering excellent care, preventing suffering at life's end, and acting according to a patient's wishes, should have clear legal protections. Unfortunately, under current law in most states, legality hinges on the state of mind of the physician, and whether the physician intends the death of the patient, rather than whether the treatment was appropriate for the situation and consistent with the request or consent of the patient or surrogate. The authors call for education to remedy the situation, but this is unlikely to help. Most accusers are not uneducated lay persons, but instead are physicians or healthcare professionals who are likely to object on moral or religious grounds. The only solution is legal protection for medical caregivers consistent with the informed, documented healthcare decisions of the patient or the surrogate. Intent protection will always be vulnerable to accusation and second-guessing, and will never offer real security to doctors or optimal care to their patients.