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To the Editor: We were surprised that in their article assessing patients' perspectives of what constitutes quality end-of-life care, Dr Singer and colleagues¹ did not address the issue of euthanasia. Certainly before the availability of highly active antiretroviral treatment, many patients with human immunodeficiency virus (HIV) infection asked us whether active euthanasia would be possible if their suffering became unbearable and they had no further treatment options. During an anonymous questionnaire survey among 315 persons with HIV infection in Belgium, 82% of the respondents felt that physicians should be able to help terminate life at the explicit request of a patient in severe physical pain.²

In practice, many persons with HIV infection, even if they become severely ill, do not request euthanasia. However, the knowledge that euthanasia could be available for them on request is important in enabling them to cope better with their insecure future. Therefore, to improve the . . . [Full Text of this Article]