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Arch Intern Med. 1998;158:1973-1976.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

THE NEW attention being paid to patients at the end of life,^1-2 the accelerating number of deaths preceded by the decision to withhold or withdraw life-support treatment,³ and the impassioned arguments about physician-assisted suicide⁴ all signify that a monumental change has taken place in medical care. The hospice movement has articulated the belief that aggressive, highly technological medical care is unsuitable for many individuals,⁵ and life-limiting medical decisions have become increasingly more acceptable. Even euthanasia, with its direct link to suicide, has become subject to a healthy and vigorous debate in professional journals, the mass media, and the US Supreme Court.^6-7

I am a psychiatrist whose opinions have been shaped by a decade-long series of clinical research studies investigating discontinuation of the life-support treatment of dialysis. The specialty of psychiatry is especially concerned with self-destructive behaviors, and considers with interest our society's increasing tolerance for noncurative treatments and planned deaths.⁸ . . . [Full Text of this Article]

HISTORY'S LESSONS

TERMINAL ILLNESS AND SUICIDE

A FRAMEWORK FOR SUICIDE AND LIFE-LIMITING BEHAVIORS

CONCLUSIONS

Lewis M. Cohen, MD
Department of Psychiatry
Baystate Medical Center
759 Chestnut St
Springfield, MA 01199

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