( CNN ) -- I once took care of an 84-year-old woman with end-stage heart failure who told me she could n't bear feeling short of breath any longer and pleaded with me to help her die . `` Is November 15 a good day for you ? '' she asked . Her daughter shot out of a chair at her bedside . `` Ma , do you understand what you are saying ? '' The old lady stared at her and nodded slowly . `` I ca n't take it anymore , '' she said . `` Back and forth , back and forth to the hospital . I 'd rather be dead . '' I explained that in New York state I could not assist in her suicide , though I could give her morphine to relieve her suffering . `` If you were like me , you 'd say the same thing , doctor , '' she said ruefully . `` I 'm half gone . Nobody wants to bother with you when you 're like this . '' A couple of days later , I went to the ethics committee at my hospital . I explained that surgeons had deemed my patient 's condition inoperable . Over the past couple of months she had been hospitalized several times with extreme shortness of breath due to congestive heart failure and treated with intravenous drugs . When the drugs were stopped , her heart failure symptoms quickly returned . This cycle was repeated several times before the day she asked me to help her die . `` She just does n't want to suffer anymore , '' I said . `` She does n't want to go through another episode of heart failure . She is absolutely terrified of it . '' `` I do n't see the big ethical dilemma , '' a senior internist said . `` Put her on a morphine drip to relieve her suffering . '' `` But she is n't currently suffering , '' I replied . `` So put her on a low dose and titrate it up when she develops symptoms . '' The problem was that she could go into a heart failure exacerbation very quickly . She could suffer for hours before her shortness of breath was brought under control , and that was in the hospital where nurses were with her around the clock . In the end , I put my patient on a morphine drip . With her and her family 's permission , we arranged for home hospice care . But she never made it out of the hospital . I thought of this patient when reading a terribly sad column on CNN.com by Brittany Maynard , a 29-year-old with brain cancer who moved to Oregon so she can legally get a prescription for a drug that will end her life . Unfortunately , there are examples ( though rare ) where palliative or hospice care can not adequately address the anxiety and suffering of dying patients . For example , in the case of my elderly patient , how can one start morphine in a patient who is n't suffering at that precise moment ? For such patients in those rare cases , I support assisted suicide as practiced in Oregon . Through Oregon 's Death with Dignity Act , passed in 1997 , more than 1,100 people have obtained life-ending prescriptions . About 750 have used them . The law does provide safeguards against clinically depressed or mentally incompetent patients getting lethal drugs to end their lives . Four other states have enacted similar laws . However , I still believe that for most terminally ill patients , hospice care is a better option than assisted suicide . Hospice offers team-based care with family involvement , often in a patient 's home , that focuses on pain management and dying with some comfort and dignity . Hospice staff is available 24 hours a day , seven days a week . The modern hospice movement started in 1967 , when Dame Cicely Saunders , a nurse , opened St. Christopher 's Hospice in London . Saunders formulated three principles for easing the process of dying : relief of physical pain , preservation of dignity , and respect for the psychological and spiritual aspects of death . The number of American hospitals offering palliative care has nearly doubled since 2000 , growing to nearly 1,500 programs -- the majority of hospitals . Perhaps the most surprising finding from these programs is that hospice patients live a month longer on average than similar patients who do not receive such care . Unlike hospice care , assisted suicide is obviously a final and irreversible act . Ruling out the presence of clinical depression that may cloud a patient 's judgment is not always straightforward . When depression lifts , the desire to die often lifts too . Only between 10 % and 15 % of people who attempt suicide eventually die by their own hands , suggesting that the desire to die is often changeable . As a doctor , I would like assisted suicide to be safe and available , but rare . Managing end-of-life care for patients like Brittany Maynard is never simple . I often think of what the elderly woman with terminal heart disease who asked me to help her die told me : `` My husband said the hardest thing to do is to die ; I always thought it would be easy . ''
Dr. Sandeep Jauhar : patient asked him for help dying ; daughter was horrified . He says he gets terminal patient Brittany Maynard 's desire to die , supports suicide in rare cases . But he says health care better option for terminally ill ; allows dignity , comfort of home , family . Jauhar : depression may cloud patient 's judgment . When it lifts , so may desire for suicide .