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Amy J. Markowitz, JD; Michael W. Rabow, MD

JAMA. 2007;298:217.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

On January 17, 2007,¹ authors Sriram Yennurajalingam, MD, and Eduardo Bruera, MD, presented the case of Mrs D, an 82-year-old retired nurse with a history of interstitial lung disease, hypertension, coronary disease, osteoporosis, gastroesophageal reflux disease, and anemia, with a recent admission for pneumonia. Her surgical history included a colectomy secondary to a perforated diverticulum and gastrointestinal bleeding. Due to dyspnea, Mrs D became increasingly dependent on supplemental oxygen for her daily activities. She lived independently and had a living will; she had asked to not undergo attempted resuscitation. Her daughter, with whom she was very close, was her durable power of attorney for health care.

Mrs D's most pervasive complaint was fatigue—often profound, and debilitating to the point that it was functionally and cognitively limiting. Her primary care physician, Dr K, a palliative care specialist, suspected that her fatigue stemmed from . . . [Full Text of this Article]