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Peter A. Goodwin, MD
Oregon Health Sciences University Portland

JAMA. 1995;274(4):302-303.

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

In Reply.

—My comments about the "double effect" and "sedating patients into oblivion" were not intended as a blanket indictment of the medical profession, but were intended to reflect on what is still a common practice. Nor was I calling into question the value of truly knowledgeable and compassionate management of pain in the dying patient, so well outlined by Dr Rousseau. However, Rousseau seems to agree that we are far from such ideal management of the competent, terminally ill patient who is encouraged at all times to participate in management decisions and whose pain is effectively treated.

Because of the passage of ballot measure 16, many initiatives have been taken in Oregon to improve the care provided to the terminally ill, including the creation of a multidisciplinary "comfort care team" at Oregon Health Sciences University as described by Dr Tolle.¹ That goal, to improve care of the terminally . . . [Full Text PDF of this Article]

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