Social implications of chronic terminal illness

Nature

The very fact of being so ill greatly increases the likelihood of control of the terminally ill by others. At the same time, the period of dependency and slow deterioration of health and strength that people undergo has lengthened.

The terminally ill commonly desire death if they must undergo severe uncontrolled pain, or they are afraid of it, and if they do not receive adequate support from friends and relatives. They may become depressed, and then be less interested in prolonging their life.

Incidence

There has been a dramatic shift toward institutionalization of the aged and those near death. Over 80% of Americans now die in a hospital or other institution. About 25% die in pain, but in only 1 to 2% of the cases is the pain unavoidable.

Claim

A terminally ill person who is not informed that his illness is incurable and that he is near death cannot make decisions about the end of his life: whether to undergo the artificial safety of a hospital to perhaps gain a little longer life; where to spend his last days; how to put his affairs in order.