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To the Editor: Dr Emanuel and colleagues¹ may report the most useful data that can be obtained from 355 active oncologists concerning physician-assisted suicide (PAS) and euthanasia. However, a comparison with the article by Quill and associates² raises several semantic questions that ethicists need to clarify before such surveys can be useful in discussions with patients or their families.

Quill et al pointed out that terminal sedation may imply that an injection will cause death, but the death is not intended, only foreseen. Local oncologists I spoke with have never seen the word terminal written before a drug order. Emanuel et al state that "withholding life-sustaining treatments and providing narcotics for pain relief that shorten a patient's life . . . are neither euthanasia nor PAS." However, in his useful 1994 table,³ Emanuel listed PAS as 1 of 6 examples of euthanasia, 3 of which were nonintentional euthanasias. The warning . . . [Full Text of this Article]

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