Doctor, I Want to Die. Will You Help Me?

Timothy E. Quill, MD
JAMA. 1993;270(7):870-873. doi:10.1001/jama.1993.03510070092043.
Text Size: A A A
Published online

IT HAD been 18 months since a 67-year-old retired man whose main joy in life was his two grandchildren was diagnosed with inoperable lung cancer. An arduous course of chemotherapy helped him experience a relatively good year where he was able to remain independent, babysitting regularly for his grandchildren.

Recent tests revealed multiple new bony metastases. An additional round of chemotherapy and radiation provided little relief. By summer, pain and fatigue became unrelenting. He was no longer able to tolerate, much less care for, his grandchildren. His wife of 45 years devoted herself to his care and support. Nonetheless, his days felt empty and his nights were dominated by despair about the future. Though he was treated with modern pain control methods, his severe bone pain required daily choices between pain and sedation. Death was becoming less frightening than life itself.

See also pp 874 and 875.

A particularly severe


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.