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Whose Death Is It, Anyway
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
The essay by Hansot [1] on the intensive care given to her dying, 87-year-old mother was very moving and informative. However, in the context of the trenches of medical practice in communities around the United States, the essay did not address three major issues. In all fairness, Dr. Hansot should deal with these issues if this discussion is to be a source of information and education to physicians.
First, Dr. Hansot neglected to deal with the issue of malpractice. Many malpractice suits have resulted from withdrawing life support, even when legal documents clearly expressed the patient's wishes to have life support discontinued.
Second, Dr. Hansot did not address the unpleasant, but very real, issue of medical insurance. I do not believe that any of the 40 million uninsured Americans would have been subjected to the barrage of multispecialists and multispecialty care that Dr. Hansot's mother was subjected to. This is an unfortunate bottom line consideration for both physicians and hospitals.
The last issue is the very unpleasant and difficult problem of dealing with the same medical facts in a patient half or one quarter the age of Dr. Hansot's mother. What would Dr. Hansot suggest that a physician have done if the patient had been 25 years old with a terminal disease?
I applaud Dr. Hansot's essay and acknowledge her emotional turmoil. However, to deal with this problem in an in-depth medical and ethical manner, one must address the more difficult problems of medical practice. These problems are presented by elderly patients with no realistic hope of an acceptable quality of life.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
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