FATAL DOSES

By DAVID VAN BIEMA

Throughout the debate over assisted suicide, it has been understood that a certain number of American doctors--between 7% and 9%, say researchers--have been willing to help desperate patients die, regardless of legal sanction. But a study in last week's New England Journal of Medicine provides a grim window into the revised norms of a plague community. A group led by clinical psychologist Lee Slome reports that in a survey of 118 San Francisco-area physicians working with AIDS patients, 53% indicated (via an anonymous, self-administered questionnaire) that they had knowingly prescribed a deadly dose of narcotics to patients who wanted to die. Most of the doctors who provided such aid, says Slome, did so from one to three times. One doctor admitted to 100 instances, a tally far outstripping that of Dr. Jack Kevorkian. (Kevorkian, of course, practices a more activist suicide assistance.)

The report hints at the ravages and despair that can attend advanced AIDS, and of the partnership that can develop between long-term HIV patients and their physicians. But its findings can be used by either side in the legal debate. Champions of a perceived constitutional right to assisted suicide will argue that if so many doctors lacking Kevorkian's idiosyncrasies feel impelled to break a law on their patients' behalf, that law probably needs retooling. Opponents, however, may suggest that the current system works just fine: a statute outlawing assisted suicide, loosely enforced, will be reluctantly violated by doctors when necessary but will still express society's view that euthanasia--whether practiced by relatives, health-care organizations or a government out to save money--remains taboo.

--By David Van Biema