Drugs used in physician-assisted death.

Epidemiological studies, case reports, and recommendations concerning the drugs used in physician-assisted death are reviewed in this paper. Using a MEDLINE and Cancerlit search, we found a total of 20 relevant publications. Recent research, mainly from the Netherlands, has shown that high doses of barbiturates are usually effective for physician-assisted suicide, while a combination of a barbiturate and a derivative of curare are effective for euthanasia. Opioids are less reliable drugs for physician-assisted death because of the unpredictable duration of the dying process even after high doses. The same applies to benzodiazepines. The most frequent undesired effect is an unexpectedly long dying process due to impaired uptake of the drugs. Although the evidence base is incomplete, the Dutch recommendations issued in 1994 and renewed in 1998 do not seem inappropriate.