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By Charles F. McKhann

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

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6 The conflict is the same; the demented person may be living happily from day to day or, as we have seen, he may be tormented by the progression of the disease and the bleakness of the future. The demented person may be comfortable, carefree or even playful, but perhaps a year or two later may be physically restrained to a chair or bed, medicated for control, and covered with bed sores smeared with excrement. The law professor and medical ethicist Ronald Dworkin wrote < previous page page_25 next page > < previous page page_26 next page > Page 26 eloquently on dignity and rights of the demented person: "A person's dignity is normally connected to his capacity for self-respect.

Previous page page_30 next page > < previous page page_31 next page > Page 31 Personal losses that can cause intense suffering include loss of independence and dignity, as well as such basic abilities as walking, talking, or reading; strength, physical beauty, or sexual attractiveness; the ability to work and retain one's role as breadwinner or homemaker; and one's place in the community or family. A patient with lymphoma described his condition: "My major problem is total loss of strength. I'm as weak as a wet noodle.

Be < previous page page_34 next page > < previous page page_35 next page > Page 35 fore the 1960s, the word cancer was rarely used in front of a patient. We had a variety of euphemisms, like "mitotic disease," by which we communicated with each other without using the dread word. Without knowing the nature of their diseases, patients could not possibly participate in any treatment decisions. At that time, few patientsmuch less their doctorsexpected such participation. As a resident at Massachusetts General Hospital in 1960, I spent several weeks assisting Dr.

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