A dying patient: the question of euthanasia.

Mrs. A. B., a 61-year-old woman who presented with carcinoma of the breast in 1964, was readmitted to the hospital in 1974 in respiratory distress ensuing from chronic lung disease and metastatic illness. An active member of Alcoholics Anonymous for the past sixteen years, she had a living pattern in which she felt in control of herself, and from which she derived an important sense of self-esteem. Although in the hospital she requested that no extraordinary measures be taken to prolong her life, when she went into respiratory failure the house staff on duty intubated her and placed her in the Intensive Care Unit. Even though her physical condition rapidly improved, the patient told her own physician that she wanted to be extubated and off Intensive Care, despite her knowledge of a probable short survival. When her request was agreed to, contrary to expectations, she continued to improve. A lawyer, interested in problems of dying and euthanasia, interviewed her, and subsequently Psychosocial Rounds were held. The general conclusions at the Rounds were that she would die an appropriate death, and that euthanasia would not be possible under current circumstances. The staff at the Conference decided to accept at face value her request that she be allowed to die without heroic measures and with dignity.