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Palliative Options at the End of Life
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To the Editor.—Dr Quill and colleagues1 try to minimize logically the differences between voluntarily stopping eating and drinking (VSED) and 3 physician-based actions: terminal sedation (TS), physician-assisted suicide (PAS), and voluntary active euthanasia (VAE). The authors propose categories of safeguards to minimize the abuse of these physician-based actions, apparently believe that TS, PAS, and VAE should be accepted medical procedures, and even suggest that "physicians who choose not to participate because of personal moral considerations should at a minimum discuss all available alternatives in the spirit of informed consent and respect for patient autonomy."
Quill et al seem to consider VSED by a patient as a medical procedure, when in fact, VSED is an independent decision made by a patient (which the authors admit "potentially requires no participation by a physician"). Physicians have an option of imposing artificial nutrition when a patient decides on VSED, thereby delaying the patient's . . . [Full Text of this Article]
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Palliative Options of Last Resort: A Comparison of Voluntarily Stopping Eating and Drinking, Terminal Sedation, Physician-Assisted Suicide, and Voluntary Active Euthanasia
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JAMA. 1997;278(23):2099-2104.
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