Communicating suffering in the context of medically assisted suicide: Psychological challenges and ethical discussion

Typically, one of the necessary conditions for accessing medically assisted suicide (MAS) is the presence of suffering that the patient deems intolerable, which is then communicated to the physician. During the consultation, the physician has the responsibility to explore this suffering, if the patient so wishes, to identify appropriate palliative care (PC) options to propose. However, the patient might desire to end life; thus, the physician is in the difficult position of offering forms of care directed at symptom relief and the preservation of life while the patient approaches the physician to request death through medical intervention. How can the physician's duty to verify the presence of intolerable suffering (a crucial yet inherently subjective and indisputable criterion based on the principle of self-determination) be reconciled with their obligation to offer PC, thereby encouraging the patient to actively engage in the therapeutic relationship through communication? This complex question, which intertwines ethical and psychological dimensions, will be the central focus of this contribution.