Diane was a patient of Dr. Timothy Quill, who was diagnosed with acute myelomonocytic leukemia. Diane overcame alcoholism and had vaginal cancer in her youth. She had been under his care for a period of 8 years, during which an intimate doctor-patient bond had been established. It was Dr. Quill's observation that "she was an incredibly clear, at times brutally honest, thinker and communicator." This observation became especially cogent after Diane heard of her diagnosis. Dr. Quill informed her of the diagnosis, and of the possible treatments. This series of treatments entailed multiple chemotherapy sessions, followed by a bone marrow transplant, accompanied by an array of ancillary treatments. At the end of this series of treatments, the survival rate was 25%, and it was further complicated in Diane's case by the absence of a closely matched bone-marrow donor. Diane chose not to receive treatment, desiring to spend whatever time she had left outside of the hospital. Dr. Quill met with her several times to ensure that she didn't change her mind, and he had Diane meet with a psychologist with whom she had met before. Then Diane complicated the case by informing Dr. Quill that she be able to control the time of her death, avoiding the loss of dignity and discomfort which would precede her death. Dr. Quinn informed her of the Hemlock Society, and shortly afterwards, Diane called Dr. Quinn with a request for barbiturates, complaining of insomnia. Dr. Quinn gave her the prescription and informed her how to use them to sleep, and the amount necessary to commit suicide. Diane called all of her friends to say goodbye, including Dr. Quinn, and took her life two days after they met.
This is a fascinating case because it presents the distinction between a patient's right to refuse treatment and a physician's assistance with suicide. Legally, Diane possessed the right to refuse treatment, but she would have faced a debilitating,... [continues]
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