Responding to Intractable Terminal Suffering
Authors: Timothy E. Quill
Journal: Annals of Internal Medicine (2000)

Letters3 October 2000Responding to Intractable Terminal SufferingTimothy E. Quill, MD and Ira R. Byock, MDTimothy E. Quill, MDThe Genesee Hospital; Rochester, NY 14607 (Quill)University of Montana; Missoula, MT 59812 (Byock) and Ira R. Byock, MDThe Genesee Hospital; Rochester, NY 14607 (Quill)University of Montana; Missoula, MT 59812 (Byock)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-7-200010030-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Yanow and Krakauer are concerned about misinterpretation of the term terminal sedation. This term was chosen after considerable discussion within the College's End-of-Life Care Consensus Panel. Dr. Yanow rightly sees that we are distinguishing terminal sedation from the usual situation of "double effect," in which death is unintended but the increased risk for death is foreseen (1). He fears that adverse judicial interpretation of a physician's intention in cases of terminal sedation may cause physicians to underprescribe in other settings.Dr. Krakauer notes that "palliative sedation," sometimes called "heavy sedation," is used to relieve severe symptoms in other ...References1. Quill TE, Dresser R, Brock DW. The rule of double effect—a critique of its role in end-of-life decision making. N Engl J Med. 1997;337:1768-71. CrossrefMedlineGoogle Scholar2. Quill TE, Lo B, Brock DW. Palliative options of last resort: a comparison of voluntarily stopping eating and drinking, terminal sedation, physician-assisted suicide, and voluntary active euthanasia. JAMA. 1997;278:2099-104. CrossrefMedlineGoogle Scholar3. Devettere RJ. The imprecise language of euthanasia and causing death. J Clin Ethics. 1990;1:268-77. MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: The Genesee Hospital; Rochester, NY 14607 (Quill)University of Montana; Missoula, MT 59812 (Byock) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoResponding to Intractable Terminal Suffering: The Role of Terminal Sedation and Voluntary Refusal of Food and Fluids Timothy E. Quill , Ira R. Byock , and Palliative Treatment of Last Resort and Assisted Suicide Daniel P. Sulmasy , Wayne A. Ury , Judith C. Ahronheim , Mark Siegler , Leon Kass , John Lantos , Robert A. Burt , Kathleen Foley , Richard Payne , Carlos Gomez , Thomas J. Krizek , Edmund D. Pellegrino , and Russell K. Portenoy Palliative Treatment of Last Resort and Assisted Suicide Timothy E. Quill , Barbara Coombs Lee , and Sally Nunn Publication of Papers on Assisted Suicide and Terminal Sedation Daniel P. Sulmasy , Wayne A. Ury , Judith C. Ahronheim , Mark Siegler , Leon Kass , John Lantos , Robert A. Burt , Kathleen Foley , Richard Payne , Carlos Gomez , Thomas J. Krizek , Edmund D. Pellegrino , and Russell K. Portenoy Publication of Papers on Assisted Suicide and Terminal Sedation Lois Snyder Publication of Papers on Assisted Suicide and Terminal Sedation Frank Davidoff Responding to Intractable Terminal Suffering Morton Leonard Yanow Responding to Intractable Terminal Suffering Eric L. Krakauer Responding to Intractable Terminal Suffering Daniel P. Sulmasy , Wayne A. Ury , Judith C. Ahronheim , Mark Siegler , Leon Kass , John Lantos , Robert A. Burt , Kathleen Foley , Richard Payne , Carlos Gomez , Thomas J. Krizek , Edmund D. Pellegrino , and Russell K. Portenoy Metrics Cited ByPhysician-reported practices on continuous deep sedation until death: A descriptive and comparative studyIntentional Sedation to Unconsciousness at the End of Life: Findings From a National Physician SurveyCommunicating about Spiritual Issues with Cancer PatientsThe use of observational scales to monitor symptom control and depth of sedation in patients requiring palliative sedation: A systematic reviewAn Integrated view of Suffering in Palliative CareETHICAL ASPECTS OF PALLIATIVE CARE IN NEUROLOGYSuicidio médicamente asistido en el final de la vidaPalliative sedation vs. terminal sedation: What's in a name? 3 October 2000Volume 133, Issue 7Page: 561-562KeywordsBurnsFearMotivationNutritionPalliative carePatient advocacyPsychiatry and mental healthSedationSedatives ePublished: 3 October 2000 Issue Published: 3 October 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...