ABSTRACT

Western medicine is experiencing a growing call for self-determination in health-care decision making. The long-held stance that doctors 'know best' and that medical interventions should aim to keep patients alive at any cost is being challenged in medical, social, spiritual, and ethical circles nationwide. A growing number of choices are available to patients who wish to have a say in the timing of their dying. Conflicting internal and organizational values that arise amidst these currents of change can create environments that are ripe for countertransference acting out on both subjective and systemic levels. In addition to bringing our professional ethics and values to our work in palliative and end-of-life care, medical providers may consciously or unconsciously respond to requests for aid in dying in ways that reflect personally held religious, moral, or cultural values that conflict with those of their patients.