To the Editor.—Dr Quill and colleagues1try to minimize logically the differences between
voluntarily stopping eating and drinking (VSED) and 3 physician-based actions:
terminal sedation (TS), physician-assisted suicide (PAS), and voluntary active
euthanasia (VAE). The authors propose categories of safeguards to minimize
the abuse of these physician-based actions, apparently believe that TS, PAS,
and VAE should be accepted medical procedures, and even suggest that "physicians
who choose not to participate because of personal moral considerations should
at a minimum discuss all available alternatives in the spirit of informed
consent and respect for patient autonomy."
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