¡¡¡¡On another level, many in the medical community acknowledge that the assisted-suicide debate has been fueled in part by the despair of patients for whom modern medicine has prolonged the physical agony of dying.ª¥

¡¡¡¡Just three weeks before the Court¡¯s ruling on physician-assisted suicide, the National Academy of Science (NAS) released a two-volume report, Approaching Death: Improving Care at the End of Life. It identifies the undertreatment of pain and the aggressive use of ¡°ineffectual and forced medical procedures that may prolong and even dishonor the period of dying" as the twin problems of end-of-life care.ª¥

¡¡¡¡The profession is taking steps to require young doctors to train in hospitals, to test knowledge of aggressive pain management therapies, to develop a Medicare billing code for hospital-based care, and to develop new standards for assessing and treating pain at the end of life.

¡¡¡¡Annas says lawyers can play a key role in insisting that these well-meaning medical initiatives translate into better care. ¡°Large numbers of physicians seem unconcerned with the pain their patients are needlessly and predictably suffering," to the extent that it constitutes ¡°systematic patient abuse." He says medical licensing boards ¡°must make it clear¡­that painful deaths are presumptively ones that are incompetently managed and should result in license suspension."