Respecting and promoting patient control has been one of the driving forces behind the hospice movement and right-to-die issues that range from honoring living wills to promoting euthanasia (mercy killing). These issues can create a conflict between a patient's desire for control and a physician's duty to promote health. These are issues of law, ethics, medicine, and philosophy. Some physicians may favor strong pain control and approve of the right of patients to refuse life support, but do not favor euthanasia or assisted suicide. Often patients who ask for physician-assisted suicide can be treated by increasing the patient's comfort and relieving symptoms, thereby reducing the patient's need for drastic measures. Patients with the desire to die should be carefully evaluated and treated for depression.

(See the PDQ summary on Last Days of Life ¹ for more information.)

Glossary Terms

A mental condition marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with normal daily life. Other symptoms of depression include feelings of worthlessness and hopelessness, loss of pleasure in activities, changes in eating or sleeping habits, and thoughts of death or suicide. Depression can affect anyone, and can be successfully treated. Depression affects 15-25% of cancer patients.

An easy or painless death, or the intentional ending of the life of a person suffering from an incurable or painful disease at his or her request. Also called mercy killing.

A program that provides special care for people who are near the end of life and for their families, either at home, in freestanding facilities, or within hospitals.

A type of legal advance directive in which a person describes specific treatment guidelines that are to be followed by health care providers if he or she becomes terminally ill and cannot communicate. A living will usually has instructions about whether to use aggressive medical treatment to keep a person alive (such as CPR, artificial nutrition, use of a respirator).

Refers to the practices and procedures used for the prevention, treatment, or relief of symptoms of a diseases or abnormal conditions. This term may also refer to a legal drug used for the same purpose.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

Medical doctor.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.