Death: the final stage of confusion

The sensitive case presentation by Barbara Springer Edwards and Winston M. Ueno, concerning a patient's desire to be sedated and disconnected from a respirator, furnishes much material for discussion. One issue: When a patient refuses treatment, what are the limits of the health-care provider's obligation to persuade the patient to accept or continue with treatment? I say "limits" advisedly, for the obligation has both a floor (the least that one must attempt) and a ceiling (beyond which efforts to persuade become medical harassment).... Another point concerns the language we all use to describe the experiences of patients. My wife, Barbara, rails at how doctors use the terms "distress" and "discomfort" -- a usage that, she points out, has infected her husband as well. She is right to rail. Someone who calls the suffocation caused by disconnecting a respirator "distressing" or "uncomfortable" will call the Gulf War a "spat."... The main issue this discussion by Edwards and Ueno raises for me, though, is that of the manner and meaning of dying.