Doctors should ease the dying of their hopelessly ill patients by giving them as much pain medicine as they need and even helping them commit suicide, if they wish, a report released Thursday concludes.

The report, drawn up by a panel of prominent physicians, contends that doctors have an obligation to help terminally ill patients have "a good death," just as they help them lead a healthy life."We really think that the physician has a responsibility to be actively involved in creating an environment in which a peaceful death can occur," said Dr. Sidney H. Wanzer, principal author of the report.

The most controversial of the group's conclusions was that "it is not immoral for a physician to assist in the rational suicide of a terminally ill patient."

Wanzer said doctors can ethically prescribe sleeping pills or other drugs to dying patients, knowing they will use them for suicide, and even tell them how big a dose is lethal.

The doctors said such assistance is "certainly not rare." However, they added that if physicians tend to their dying patients' comfort and dignity, suicide requests should be infrequent.

The report is the second from the committee, which was chaired by Dr. Daniel D. Federman of Harvard Medical School, former president of the American College of Physicians. It was published in Thursday's New England Journal of Medicine.