Yet the reality of existing medical practice in doctors' offices and hospitals across the state generally cannot match these expectations, however many guidelines or safeguards might be framed. These realities render legislation to legalize assisted suicide and euthanasia vulnerable to error and abuse for all members of society, not only for those who are disadvantaged. In sum, the presupposition that dying patients are capable of making voluntary decisions concerning suicide or direct killing, that is, decisions which are free from moral coercion, is simply unrealistic. Thus, when physicians are unable to alleviate pain they have failed in their profession. To put it another way, the authors presuppose that in the presence of pain that cannot be alleviated through medical care the only alternative is patient or physician inflicted death.
Many people live with pain and in the face of death gain strength from their family and friends.
A holistic evaluation of a dying person's situation requires a distinction between pain and suffering. A distinction not made in the article under study. Often people can bear pain if loved ones share their suffering. It seems that the assumption that only members of the medical profession are responsible and capable of helping people cope with pain and imminent death is short sighted. In addition, it bespeaks a latent paternalism which the authors of this article would loudly denounce in other circumstances.