Abstract
Practices considered controversial only a few years ago -- including DNR orders, withdrawal of nutrition and hydration from hopelessly ill or comatose patients, and the rights of patients to make health care decisions -- have won public, professional, and court support. Deficiencies remain in the formulation of institutional policies, implementation of such practices, and training of medical personnel to deal with the issues involved. Physicians have responsibility to ensure that patient wishes about life sustaining treatment and terminal care are discussed, to develop a care plan that takes into account the patient's needs, and to reassure patients that pain relief will be aggressively pursued. The authors review the home, nursing home, and hospital as alternative settings for dying and examine the physician's role in assisted suicide and active, voluntary euthanasia. (KIE abstract)
