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Ideas and Opinions |

The Man with Stars Inside

Jack Coulehan, MD
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From State University of New York at Stony Brook, Stony Brook, New York. For the current author address, see end of text. Acknowledgments: The author thanks Professor Peter Williams and Father Robert Smith at Stony Brook for their thoughtful comments and suggestions on earlier drafts of “The Man with Stars Inside”; the reviewer whose suggestions helped sharpen the focus of this essay; and Nightshade Press (Troy, Maine) for publishing the author's volume of poetry, The Knitted Glove (1991), in which the poem “The Man with Stars Inside” first appeared. Requests for Reprints: Jack Coulehan, MD, Institute for Medicine in Contemporary Society, Health Sciences Center L3-092, State University of New York at Stony Brook, Stony Brook, NY 11794-8036.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1997;126(10):799-802. doi:10.7326/0003-4819-126-10-199705150-00010
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Public opinion polls show that a large percentage of persons in the United States currently favor the legalization of professionally assisted death.This support reflects wide-spread fear and confusion over the tortuously prolonged and painful process of dying countenanced by contemporary medicine. Physician-assisted suicide and euthanasia are complex moral issues. The current drive to translate them into debates about “rights” and public policy is curious: Does the energy directed toward “palliation-by-death” mean that our society is more compassionate now, or more just, than in the past? To the contrary, I believe that the movement toward assisted death reflects inadequate palliative care, poor patient–physician communication, great confusion about the right to refuse treatment, and profound inequity in U.S. health care. Legalization of assisted death diverts us from addressing these problems. Palliation-by-death will drive us farther apart, not closer together.

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