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January 1, 1992, Vol 267, No. 1 >
ARTICLE | January 1, 1992

Who Should Decide About Your Death? FREE

Carl M. Kjellstrand, MD, PhD, FRCPC
[+] Author Affiliations

Reprint requests to Division of Nephrology, Department of Medicine, 2E3.31 Walter Mackenzie Centre, Edmonton, Alberta, Canada T6G 2B7 (Dr Kjellstrand).


JAMA. 1992;267(1):103-104. doi:10.1001/jama.1992.03480010111036
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References

In our technological hubris, we have mismanaged dying: the only certain ultimate outcome of all our busy efforts.

Most of us would like to die a quiet, dignified death.1 Anyone who works in a hospital knows that this reasonable wish is almost never fulfilled and most of us now die in hospitals. The last rites of respirators, dialysis machines, nasogastric tubes, and gastrostomy tubes along with cardiopulmonary resuscitation and the nth round of chemotherapy are wonderful when prolonging useful life but have changed death to a mechanized spectacle in which no sane person would like to be the main actor.

See also p 59.

To the patients, it often appears as if there is nobody in charge of the myriads of nurses and technicians, of attending physicians, consultants, residents, fellows, interns, administrators, and lawyers. They are right: no one is in charge. Scared physicians and cowardly hospital administrators

REFERENCES

1 +
Shneidman ES.  National survey of attitudes toward death.  In: Fulton R, Markusen E, Owen G, Scheiber TJ, eds. Death and Dying . Reading, Mass: Addison-Wesley Publishing Company; 1978;:23-33.
2 +
Annas GJ.  Prisoner in the ICU: the tragedy of William Bartling. Hastings Cent Rep . 1984;;14:28-29.
3 +
Nelson LJ, Cranford RE.  Legal advice, moral paralysis and the death of Samuel Linares. Law Med Health Care . 1989;;17:316-324.
4 +
Lo B, Steinbrook R.  Beyond the Cruzan case. Ann Intern Med . 1991;;114:895-901.
5 +
Cruzan v Missouri Dept Health, 497 Mo, 111 LEdId 224, 110 SCt 2841 (1990).
6 +
US Congress. Patient Self-Determination Act. Omnibus Budget Reconciliation Act of 1990. Pub L No. 101-508.
7 +
Lo B, McLeod GA, Saika G.  Patient attitudes to discussing life-sustaining treatment. Arch Intern Med . 1986;;146:1613-1615.
8 +
Greco PJ, Schulman KA, Larizzo-Mourey R, Hausen-Flaschen J.  The Patient Self-determination Act. Ann Intern Med . 1991;;115:639-643.
9 +
Sehgal A, Galbraith A, Chesney M, Schoenfeld P, Charles G, Lo B.  How strictly do dialysis patients want their advance directives followed? JAMA . 1992;; 267: 104-105.
10 +
Neu S, Kjellstrand CM.  Stopping long-term dialysis. N Engl J Med . 1986;;314:14-20.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Shneidman ES.  National survey of attitudes toward death.  In: Fulton R, Markusen E, Owen G, Scheiber TJ, eds. Death and Dying . Reading, Mass: Addison-Wesley Publishing Company; 1978;:23-33.
2 +
Annas GJ.  Prisoner in the ICU: the tragedy of William Bartling. Hastings Cent Rep . 1984;;14:28-29.
3 +
Nelson LJ, Cranford RE.  Legal advice, moral paralysis and the death of Samuel Linares. Law Med Health Care . 1989;;17:316-324.
4 +
Lo B, Steinbrook R.  Beyond the Cruzan case. Ann Intern Med . 1991;;114:895-901.
5 +
Cruzan v Missouri Dept Health, 497 Mo, 111 LEdId 224, 110 SCt 2841 (1990).
6 +
US Congress. Patient Self-Determination Act. Omnibus Budget Reconciliation Act of 1990. Pub L No. 101-508.
7 +
Lo B, McLeod GA, Saika G.  Patient attitudes to discussing life-sustaining treatment. Arch Intern Med . 1986;;146:1613-1615.
8 +
Greco PJ, Schulman KA, Larizzo-Mourey R, Hausen-Flaschen J.  The Patient Self-determination Act. Ann Intern Med . 1991;;115:639-643.
9 +
Sehgal A, Galbraith A, Chesney M, Schoenfeld P, Charles G, Lo B.  How strictly do dialysis patients want their advance directives followed? JAMA . 1992;; 267: 104-105.
10 +
Neu S, Kjellstrand CM.  Stopping long-term dialysis. N Engl J Med . 1986;;314:14-20.

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