Palliative Treatment of Last Resort and Assisted Suicide
Authors: TE Quill,  Coombs Lee B, S Nunn
Journal: Annals of Internal Medicine (2000)

Letters3 October 2000Palliative Treatment of Last Resort and Assisted SuicideTimothy E. Quill, MD, Barbara Coombs Lee, PA, FNP, JD, and Sally Nunn, RNTimothy E. Quill, MDThe Genesee Hospital; Rochester, NY 14607 (Quill)Compassion in Dying Federation; Portland, OR 97201 (Coombs Lee)University of Pennsylvania Center for Bioethics; Philadelphia, PA 19104 (Nunn)Search for more papers by this author, Barbara Coombs Lee, PA, FNP, JDThe Genesee Hospital; Rochester, NY 14607 (Quill)Compassion in Dying Federation; Portland, OR 97201 (Coombs Lee)University of Pennsylvania Center for Bioethics; Philadelphia, PA 19104 (Nunn)Search for more papers by this author, and Sally Nunn, RNThe Genesee Hospital; Rochester, NY 14607 (Quill)Compassion in Dying Federation; Portland, OR 97201 (Coombs Lee)University of Pennsylvania Center for Bioethics; Philadelphia, PA 19104 (Nunn)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-7-200010030-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:As palliative care practitioners have struggled to find ways to respond to intractable end-of-life suffering without resorting to physician-assisted suicide, terminal sedation and voluntarily stopping eating and drinking have been suggested as morally acceptable alternatives that do not require changes in the law (1, 2). We agree with Sulmasy and colleagues that these practices are much more morally and clinically complex than is ordinarily acknowledged (3). For this reason, we support guidance for those who might participate in these practices even though it may not be legally required (4); the University of Pennsylvania Center for Bioethics Assisted Suicide ...References1. Miller FG, Meier DE. Voluntary death: a comparison of terminal dehydration and physician-assisted suicide. Ann Intern Med. 1998;128:559-62. LinkGoogle Scholar2. Bernat JL, Gert B, Mogielnicki RP. Patient refusal of hydration and nutrition: an alternative to physician-assisted suicide or voluntary active euthanasia. Arch Intern Med. 1993;153:2723-7. CrossrefMedlineGoogle Scholar3. 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;278:1099-2104. CrossrefGoogle Scholar4. Quill TE, Byock IR. Responding to intractable terminal suffering: the role of terminal sedation and voluntary refusal of food and fluids. ACP–ASIM End-of-Life Care Consensus Panel. Ann Intern Med. 2000;132:408-14. LinkGoogle Scholar5. Ventafridda V, Ripamonti C, De Conno F, Tamburini M, Cassileth BR. Symptom prevalence and control during cancer patients' last days of life. J Palliat Care. 1990;6:7-11. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Timothy E. Quill, MD; Barbara Coombs Lee, PA, FNP, JD; Sally Nunn, RNAffiliations: The Genesee Hospital; Rochester, NY 14607 (Quill)Compassion in Dying Federation; Portland, OR 97201 (Coombs Lee)University of Pennsylvania Center for Bioethics; Philadelphia, PA 19104 (Nunn) 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 Treatments of Last Resort: Choosing the Least Harmful Alternative Timothy E. Quill , Barbara Coombs Lee , Sally Nunn , and 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 Responding to Intractable Terminal Suffering Timothy E. Quill and Ira R. Byock 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 Metrics 3 October 2000Volume 133, Issue 7Page: 563KeywordsBioethicsDecision makingEatingFoodPalliative carePatientsPsychiatry and mental healthSedationSuicide ePublished: 3 October 2000 Issue Published: 3 October 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...