The College's decision to oppose the legalization of physician-assisted suicide was made after a serious, reasoned consideration of a wide variety of points of view and after a thorough examination of the medical, ethical, legal, and social ramifications of legalizing this practice.

Drs. Leeman and de Torrenté raise some of the issues we considered but do not explain the basis for the right to physician-assisted suicide that they support. They also fail to acknowledge the debate about the appropriate role of medicine in caring for patients at the end of life. The College argued that medicine cannot and should not be asked by society to attempt to relieve all human suffering and that it is not for physicians to end suffering by directly causing death. Drs. Leeman and de Torrenté focus not on arguments of principle but on practical issues like the potential for abuse and slippery slopes—-important issues that we also considered. They do not focus on the full picture.

Dr. Leeman is reassured by the Oregon experience because of his practical concerns about the potential for abuse and misuse in implementation of physician-assisted suicide. Reports from Oregon, however, are early and incomplete. Nonetheless, they have helped confirm that people who have chosen legalized physician-assisted suicide have done so not because of pain but because of the fear of a loss of autonomy and because they desired control over death. Dr. de Torrenté finds the idea of suffering with the patient to be "something of a lie." To be compassionate, however, literally means to suffer with another. Not only is this not "wishful thinking," it is the very soul of medicine.

Dr. Girsh is the president of an organization that exists for the purpose of promoting the widespread availability of euthanasia and assisted suicide. The College respectfully disagrees that the agenda of her organization is in the best interests of patients, health care professionals, or the United States.

We appreciate the continuing debate on this important issue.