The Oregon & Dutch experiences provide convincing evidence that legalization of assisted suicide & euthanasia undermines the care provided to patients at the end of life. The challenge we face is to create a culture that identifies the care of the seriously ill & dying as a public health issue. There needs to be a strong social commitment to both respecting the dignity & individuality of dying patients & their families, & providing them with real choices for real care at the end of life. (10 refs)