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April 28, 1999

Euthanasia and End-of-Life Care—Reply

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(16):1488. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-16-jbk0428

In Reply: When end-of-life care surfaces on television, in the newspapers, or on the radio, 9 times out of 10 the issue arises as "euthanasia" or "assisted suicide." At the bedside, however, the primary concerns of dying patients are the ones in our study—receiving adequate pain and symptom management, avoiding inappropriate prolongation of dying, achieving a sense of control, relieving burden, and strengthening relationships with loved ones. In our study, which involved patients receiving dialysis (n=48), people with HIV (n=40), and residents of a long-term care facility (n=38), euthanasia was mentioned by less than 5% of participants in each group. Is it possible that the dramatic issue of euthanasia and assisted suicide has obscured the more "mundane" personal issues that are of primary concern to dying patients?

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