A death on her terms

Re “A Patient’s Final Decision” (Aug. 23): Dr. Marc Siegel’s article about a patient who returned to the Netherlands for her final days revealed his ambivalence about permitting a patient to be in control when disease brings the end of life near. As he indicated, the patient was not ambivalent about her choice to have dying occur on her terms. Fortunately, she was able to return to her native land, where the professionals are not so determined to be in charge right to the end. Clearly, this was a rational woman, accepting the fact that death was not a remote possibility. It was not going to be a difference between living and dying. It was simply a difference in the time and location of that process.

Sometimes we physicians have to help a patient accept that a disease is present that will end life. I believe it should be the responsibility of a physician to help a patient find a more peaceful dying process when that person is mentally competent and has made the decision that there is no more joy left in living.

Dr. Richard MacDonald

Medical director

End of Life Choices/

Caring Friends Program