How would you answer a patient who indicated he wanted self-assisted suicide instead of a lengthy, pain-filled period of final days?
"Spiritually, ethically, and morally I cannot take someone's life. However, the caveat of 'do no harm' means not allowing pain to dominate one's final days or moments. Those belong to him or her and loved ones--it's a special time that should not be wasted because of being consumed with pain. I can comfort a patient by whatever means becomes necessary. Although I cannot take life, I also cannot allow harm, which is what pain is, especially when it's being there or not makes no difference in the expected outcome."
"We all will die. It is inevitable. However, if the inevitable were to come sooner by a few minutes or hours because I was treating something else, like intractable pain, my patient has a right to that relief. If he or she wanted death to come sooner by months or years, however, then that is nothing less than suicide. There is a big difference between experiencing a side effect of pain relief and committing euthanasia, even if it results in the same thing. I want my patient to have the right to the former, but I am not doing my best in being an Oncologist by embracing the latter."
Your specialty is one that tries to sidestep death, but the jump out of the way isn't easy and it's never guaranteed. It makes even a rational man consider the tradeoffs in just accepting death and, to that end, even consider a 'designer' death that is easier than the alternative. You need not have a position on this subject, but siding with your patient and his or her rights may give you a way to please both sides of the issue.
"I morally feel no one is qualified to actively take a life. However, I would pledge to my patient a dedication to his or her comfort, even if it meant pain management that was fraught with the risk of side effects that brought on the inevitable sooner, such as with respiratory depression."