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To the Editor.—Dr Muskin¹ acknowledges the importance of involving psychiatrists in the evaluation of patients requesting physician-assisted suicide, but while he discusses the significance of the physical pain that often precipitates such requests, he makes little mention of the role psychiatrists should have in managing this problem.

Muskin appears to believe that nonpsychiatrists involved in the care of terminally ill patients can be depended on to have the skill to treat pain. Sadly, multiple studies have shown that many primary care physicians, oncologists, and surgeons treating these patients receive little education in this area and often provide inadequate pain management.^2-3

That psychiatrists have far more to offer to patients with pain than simply addressing their psychological issues is demonstrated by the inclusion in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) of the diagnosis of "pain disorder associated with both psychological factors and a general medical . . . [Full Text of this Article]

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RELATED ARTICLE

The Request to Die: Role for a Psychodynamic Perspective on Physician-Assisted Suicide
Philip R. Muskin
JAMA. 1998;279(4):323-328.
ABSTRACT | FULL TEXT