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Editor's Correspondence |

Interventions in End-of-Life Care

Harvey Max Chochinov, MD, PHD, FRCPC
Arch Intern Med. 2001;161(8):1117-1118. doi:.
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The article by Wilson et al1 indicates once again the close association between a dying patient's wish to see their life end sooner and both physical and especially psychological distress.25 One should interpret their data beyond that with caution.

Reporting that 73% of terminally ill participants in their study believed that euthanasia or physician-assisted suicide should be legalized seems to imply an imperative for social policy to loosen legislative prohibitions against physician-hastened death. However, it should be pointed out that the rate of endorsement reported in this small group of dying patients is no different than what has been widely reported in many public opinion polls at large.6 In that regard it would seem that dying patients are no different than others; anticipation of a painful, undignified terminal course would see many look toward the availability of physician-hastened death as a comforting (albeit rarely exercised) option. A dying patient recently told me that given the option, she would "press the button now," thus ending her life immediately. At the conclusion of that memorable session, she agreed to defer "pressing the hypothetical button" and continue to meet to explore and address the nature of her suffering. Perhaps this study might have asked an even more salient question: how many people would want their death hastened if they could be guaranteed state-of-the-art, aggressive, compassionate, completely accessible, and affordable end-of-life care?

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