0 n 15 February of this year, shortly after the number of people Dr. Jack Kevorkian had helped to commit suicide swelled to fifteen, the Michigan legislature passed a law, effective that very day, making assisted suicide a felony punishable by up to four years in prison. The law, which is automaticallv reDealed six months after a I ‘ newly established commission on death and dying recommends pe...

CONTEXT Community-based clergy are highly engaged in helping terminally ill patients address spiritual concerns at the end of life (EOL). Despite playing a central role in EOL care, clergy report feeling ill-equipped to spiritually support patients in this context. Significant gaps exist in understanding how clergy beliefs and practices influence EOL care. OBJECTIVES The objective of this stu...

BACKGROUND A screening spiritual history (SSH) is how health professionals (HP) identify patients' spiritual values, beliefs and preferences (VBPs) in the outpatient setting. We report on attitudes and practices of HPs in the largest Protestant health system in the U.S., the Adventist Health System (AHS). METHOD Physicians or mid-level practitioners (N = 1082) in AHS-affiliated practices were...

When I began my career with dual training in bioethics and law, my research and clinical interests were focused on the suffering of terminally ill adults due to unwanted treatment and how perceptions of law among health care providers contributed to this problem. A central goal of my work was to try to prevent situations where physicians would aggressively continue to treat patients in ways con...

Three commentaries are presented on a case conference, "Truth at the last--a case of obstructed death," which appeared in the March 1982 issue. The case involved collusion between a physician and a family member to withhold the truth from a terminally ill patient. The commentaries discuss the possible psychological need of dying patients to resolve "unfinished business," and the physician's g...

Approximately 10% of children grow up with a parent who has been diagnosed with a chronic medical condition (CMC) and seem to be at risk for adjustment difficulties. We examined differences in behavioral, psychosocial and academic outcomes between 161 adolescents from 101 families with a chronically ill parent and 112 adolescents from 68 families with healthy parents, accounting for statistical...

There is a terrible poignancy to the delirium experienced by a person who is dying. For those who love that person, and likely for the dying individuals themselves, there can be a sense of opportunity lost, of having left too soon. This is not an isolated phenomenon: Case series show that many, even most, patients who die of advanced cancer experience delirium (Gagnon et al., 2000; Jenkins et a...

OBJECTIVE To identify risk factors associated with self-reported medical, medication and laboratory error in eight countries. DESIGN The Commonwealth Fund's 2008 International Health Policy Survey of chronically ill patients in eight countries. INTERVENTION None. SETTING AND PARTICIPANTS A multi-country telephone survey was conducted between 3 March and 30 May 2008 with patients in Austra...

This Article explores the oftentimes mistaken notion that we can realistically identify severely ill individuals seeking physician-suicide who do so willingly, knowingly, and voluntarily. Medical science and medical practice support this proposition. To date, there exists no sound clinical basis for distinguishing suicidal patients with terminal conditions from suicidal patients without termina...