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Ideas and Opinions |

Voluntary Death: A Comparison of Terminal Dehydration and Physician-Assisted Suicide

Franklin G. Miller, PhD; and Diane E. Meier, MD
[+] Article and Author Information

From the University of Virginia, Charlottesville, Virginia; and Mount Sinai School of Medicine, New York, New York. Grant Support: Dr. Meier was supported by the United Hospital Fund, the Emily Davie and Joseph F. Kornfeld Foundation, and the Mount Sinai Hospital Auxiliary Board. Requests for Reprints: Diane E. Meier, MD, PO Box 1070, Mount Sinai Medical Center, New York, NY 10029. Current Author Addresses: Dr. Miller: 3910 Underwood Street, Chevy Chase, MD 20815.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1998;128(7):559-562. doi:10.7326/0003-4819-128-7-199804010-00007
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The controversial issue of legalizing physician-assisted suicide should be considered in light of legally available alternative methods of voluntary death. The increasingly polarized debate over this issue has failed to give due attention to an alternative: terminal dehydration. By voluntarily forgoing food and water, competent patients with terminal or incurable illness can escape intolerable, irremediable conditions without requiring transformation of the law and medical ethics. Terminal dehydration offers substantial advantages over physician-assisted suicide with respect to self-determination, access, professional integrity, and social implications but also has distinctive drawbacks as a humane means of voluntary death. This article analyzes clinical, ethical, and policy issues related to terminal dehydration compared with physician-assisted suicide.

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