Death and Dignity: Making Choices and Taking Charge

Dr. Timothy Quill put his career in danger when he wrote in the New England Journal of Medicine that he had assisted a terminally ill patient in suicide - at her request - by prescribing pills and letting her know how to take a lethal dose. He had treated "Diane" for many years, had seen her through other serious illnesses, and had responded to her desire to leave this world with her dignity still intact. But "Diane's" story was not unique. Dr. Quill received over 2,000 letters from people who read his article, and was confided in by many other persons who had witnessed severe end-of-life suffering. By sharing some of these stories, Dr. Quill hopes to increase the choices available to dying patients. Death and Dignity is about taking charge of your illness, no matter how serious. It emphasizes the necessity for honest dialogue between you and your doctor, including a thorough discussion of your feelings about death and dying. Doctors and patients must work together to investigate all health care options, from the most aggressive to those that emphasize comfort and the relief of suffering. Ultimately, the patient's values and personal goals must guide all medical choices, particularly toward the end of life. Quill advocates, as did Norman Cousins in Anatomy of an Illness, that the patient must be an active participant in the process whether the decision is to fight the illness or to come to terms with death when all reasonable options are exhausted. Through his years of practicing medicine, Dr. Quill has come to know that some incurably ill patients live beyond the point where they can find emotional or spiritual meaning in their lives. He believes that physician-assisted suicide should be an option when requested by those who suffer intolerably in spite of the best efforts of their doctor, their family, and themselves. He has seen the relief that dying can bring when living has become a nightmare with no end in sight. Dr. Quill proposes criteria that would guid

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