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ARTICLE |

Terminal Care in Patients With Chronic Lung Disease

John J. Skillman, MD
Arch Intern Med. 1979;139(8):917-919. doi:10.1001/archinte.1979.03630450059018.
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Life beings at birth and extends in a continuum to death; or does it? Is there a point when it may be said that death is beginning?1 Does it not seem that in caring for a seriously ill patient there is a point when almost every physician and nurse of experience can say to himself or herself (even though one may not outwardly express it) that the patient is beginning to die? At times there is considerable doubt when this point has been reached, for it is clearly less precise than the moment of birth or the time of death. Those who would agree that a point of beginning death can never be defined are likely to be the same ones who argue most strongly against the discontinuation of life support systems. For them the uncertainty is too great ever to give up seeking a cure. Their sensitivity to

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