The past two decades have witnessed dramatic changes in professionalvalues and social expectations regarding medical care and decisionmaking at the end of life. Increased emphasis on patients' autonomyand participation have made open discussion, both in the medicaland popular literature and at the bedside, the new norm. Theseemingly final taboo, euthanasia, is now the topic of frankpublic, intellectual, and legal debate. Although Wanzer et al.,in their 1989 second look at "The Physician's Responsibilitytoward Hopelessly Ill Patients," wrote that the "entire subjectis now discussed openly,"1 there remains a practice that hasreceived little . . . [Full Text of this Article]
When Do Slow Codes Occur?
Are Slow Codes Medically Appropriate?
Patients' Autonomy and Medical Paternalism
The Physician's Responsibility
Address reprint requests to Dr. Gazelle at Harvard Vanguard Medical Associates Division of Medicine, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115.
References
Related Letters:
The Slow Code
Segal E., Halamish-Shani T., Rich H., Greenfield L. J., Fried T. R., Wachtel T. J., Ish C., Krause R. G., Gazelle G.
Extract |
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N Engl J Med 1998;
338:1921-1923, Jun 25, 1998.
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Segal, E., Halamish-Shani, T., Rich, H., Greenfield, L. J., Fried, T. R., Wachtel, T. J., Ish, C., Krause, R. G., Gazelle, G.
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