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 reviews as a doctor, Dr. Charles McKhann argues persuasively that physician-assisted loss of life might be made legally on hand below definite situations.
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Additional info for A Time to Die: The Place for Physician Assistance
A relative of mine developed this in her early sixties. The many activities that she enjoyed all ended in less than a year. The first clue that I had of any problem was after my cousin promised to leave the key to her apartment so that we could use it when she was away. She has a nice apartment in Washington, near a park, which she let us use from time to time when she was out of town. This time she forgot to leave the key and it took many calls to locate her and finally get permission to be let in.
22 These negative forms of autonomy, which place great emphasis on protecting the right to be allowed to die, now include the right to discontinue life-sustaining support that is already in place, even if it requires the help of a physician to do so. This degree of autonomy is now well established, and the next phase of extending it even fur < previous page page_36 next page > < previous page page_37 next page > Page 37 ther is to be able to obtain help in dying when there is no supportive technology in place.
The muscles melt away until a person is unable to move. Late problems include difficulty speaking and swallowing. There are no remissions, and about half the patients die within three years. Ten percent live about ten years, and a very few live twenty years or longer. Again, death is usually from respiratory failure. It is questionable whether the use of assisted ventilation is appropriate for people whose suffering is so great and prognosis is so poor. Patients with ALS are usually mentally competent to the end, with only 5 percent developing significant dementia.