Rodney Syme, FRCS, FRACS
Syme R. Intractable Terminal Suffering. Ann Intern Med. 2000;133:749-750. doi: 10.7326/0003-4819-133-9-200011070-00030
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Published: Ann Intern Med. 2000;133(9):749-750.
TO THE EDITOR:
No doubt BG, the patient described in Quill and Byock's paper (1), was grateful for the assistance he received at the end of his life, and his palliative care attendants would say he died peacefully. But no amount of sophistry can hide the fact that he did not get the treatment he wanted: His statement “I just want to go to sleep and not wake up” reveals his true wishes, which are not always explicitly expressed by dying patients. This requires exploration of such gambits, but many in palliative care do not want to open these doors. Instead, the patient had to endure 9 days of dehydration (hardly a choice; it seems to have been his only option), an immense emotional effort, which would be described as medical neglect except that it was “voluntary.” On the 10th day, he was granted some palliation by sedation. Do the authors seriously suggest that this is a credible alternative to medically assisted suicide?
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