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By Charles F. McKhann

Drawing on in-depth interviews with those who have been loss of life and with the physicians who cared for them, in addition to on his personal reports as a doctor, Dr. Charles McKhann argues persuasively that physician-assisted demise will be made legally to be had below definite situations.

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The sense that the parting is definite and even imminent can cause great sadness and depression. Fear Fear of what may lie ahead is a form of suffering in itself. Common sources of fear include failure to control existing symptoms, the advent of new symptoms and disabilities, and the possibility of becoming helpless and a burden on others. Many fear the institutions through which they may passhospital, nursing home, hospice. The extended twilight of a lingering death casts long shadows. We may fear loss of control over our lives, dirtiness and loss of dignity, abandonment by family, friends, or physician.

29 Having looked at many reasons why a person who is seriously ill might wish to shorten his life, we must now recognize the fact that such an act, with or without help, is essentially suicide. Is it ever acceptable? < previous page page_43 next page > < previous page page_44 next page > Page 44 2 Rational Suicide: The Core of the Controversy People who insist that life must always be better than death often sound as if they are choosing eternal life in contrast to eternal death, when the fact is that they have no choice in the matter; it is death now, or death later.

As the number of elderly in the population increases, the need for supervisory and custodial care is certain to become a major public financial issue, the cost of which may soon greatly outstrip the needs of the younger people who currently have no health insurance at all. Most Western countries that have comprehensive health care systems include long-term care in their coverage so that family assets do not have to be depleted. As the numbers increase in this country, so will the political pressure, to the point where we, too, may have to provide good long-term care at public expense.

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