Abstract
Lewis Thomas has noted that doctors “are as frightened and bewildered by the act of death as everyone else”1. “Death is shocking, dismaying, even terrifying,” Thomas has written. “A dying patient is a kind of freak . . . an offense against nature itself”1. It is thus not surprising that many physicians have difficulty talking candidly with dying patients and caring for them, a reaction that often results in undermedication for pain and expensive and ineffective overtreatment.American patients know this, and although death is a culture-wide enemy, many Americans fear the process of dying in an impersonal . . .
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