Reason, courage, and grace: notes of a death watcher.

Dying is strikingly private and personal, and it breaks the interconnectedness of all human life. It is at such a time that the physician's humanity must touch the unique personhood of the afflicted if the death is to be "good". A physician's duty does not rest on the medical profession's code of conduct; it consists of the physician's moral obligation to a specific person in a specific situation. That person's entire identity--not just the physical being--is assaulted by terminal illness; the emotional, familial, and social dimensions of selfhood are ravaged by the disease as surely as is the body. Each individual is involved in his or her suffering in a way that is unique and that cannot be understood or appreciated by anyone else. But the physician must try to bridge the distance that is placed around the sufferer by the dying process. And it is only with his or her own humanity that the care giver can accomplish this. That humanity should inform all decision making, and thus bring with it genuine control and comfort. In this way the patient can truly "own" his or her own death. The patient can thereby attain reason and courage, which together are the quality of grace.