Author granted license

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International

Document Type


Publication Date





Massachusetts Medical Society




Lewis Thomas has noted that doctors “are as frightened and bewildered by the act of death as everyone else”. “Death is shocking, dismaying, even terrifying,” Thomas has written. “A dying patient is a kind of freak . . . an offense against nature itself”. It is thus not surprising that many physicians have difficulty talking candidly with dying patients and caring for them, a reaction that often results in undermedication for pain and expensive and ineffective overtreatment.

American patients know this, and although death is a culture-wide enemy, many Americans fear the process of dying in an impersonal modern hospital more than death itself. Americans say they want to die at home, quickly, painlessly, and in the company of friends and family. Most, however, die in hospitals, slowly, often in pain, and surrounded by strangers. Discussions of assisted suicide, the publication of self-help suicide books, and fascination with suicide machines are all symptoms of the problem modern medicine has with the dying, rather than solutions. The state of Michigan is struggling with this problem in its efforts to stop Jack Kevorkian.


From The New England Journal of Medicine, George J. Annas, Physician-Assisted Suicide -- Michigan's Temporary Solution, Volume 328, Page 1573 Copyright ©(1993) Massachusetts Medical Society. Reprinted with permission.

Link to Publisher Site (BU Community Subscription)



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.