Unbearable suffering without prospect of improvement
The physician must be satisfied that the patient’s suffering is unbearable and without prospect of improvement.
Without prospect of improvement
The patient’s suffering is considered to be without prospect of improvement if the disease or disorder causing the suffering is incurable and there are no means of alleviating the symptoms so that the suffering is no longer unbearable. Medically speaking, the absence of any prospects for improvement can be determined with a reasonable degree of objectivity. The physician establishes this on the basis of the diagnosis and prognosis. Whether curative or palliative treatments are a realistic option depends on two things: the improvement that can be achieved and the burden such treatment would place on the patient.
The unbearable nature of suffering is more difficult to establish because it is a subjective notion. What is bearable for one patient may be unbearable for another. Whether suffering is unbearable depends on the patient’s current situation and their future prospects, physical and mental stamina, and personality.
The unbearable nature of the patient’s suffering must be palpable to the physician. The physician must therefore not only be able to empathise with the patient’s situation, but also see it from the patient’s point of view. The physician must demonstrate convincingly to the review committee assessing the case that the suffering of this particular patient was palpable to the physician.