Terminal illness

Terminal illness or end-stage disease is an incurable disease that cannot be adequately treated and is reasonably expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer or advanced heart disease than for trauma. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. Life expectancy for terminal patients is a rough estimate given by the physician based on previous data and does not always reflect true longevity.[1] An illness which is lifelong but not fatal is a chronic condition.

Terminal patients have options for disease management after diagnosis. Examples include caregiving, continued treatment, hospice care, and physician-assisted suicide. Decisions regarding management are made by the patient and his or her family, although medical professionals may give recommendations or more about the services available to terminal patients.[2][3]

Lifestyle after diagnosis largely varies depending on management decisions and also the nature of the disease, and there may be living restrictions depending on the condition of the patient. Oftentimes, terminal patients may experience depression or anxiety associated with oncoming death, and family and caregivers may struggle with psychological burdens as well. Psychotherapeutic interventions may help alleviate some of these burdens, and is often incorporated in palliative care.[2][4]

Because terminal patients are aware of their oncoming deaths, they have more time to prepare advance care planning, such as advance directives and living wills, which have been shown to improve end-of-life care. While death cannot be avoided, patients can still strive to die a good death.[5][6][7]


By definition, there is not a cure or adequate treatment for terminal illnesses. However, some kinds of medical treatments may be appropriate anyway, such as treatment to reduce pain or ease breathing.[8]

Some terminally ill patients stop all debilitating treatments to reduce unwanted side effects. Others continue aggressive treatment in the hope of an unexpected success. Still, others reject conventional medical treatment and pursue unproven treatments such as radical dietary modifications. Patients' choices about different treatments may change over time.[9]

Palliative care is normally offered to terminally ill patients, regardless of their overall disease management style, if it seems likely to help manage symptoms such as pain and improve quality of life. Hospice care, which can be provided at home or in a long-term care facility, additionally provides emotional and spiritual support for the patient and loved ones. Some complementary approaches, such as relaxation therapy, massage, and acupuncture may relieve some symptoms and other causes of suffering.[10][11][12][13]


Terminal patients often need a caregiver, who could be a nurse, licensed practical nurse or a family member. Caregivers can help patients receive medications to reduce pain and control symptoms of nausea or vomiting. They can also assist the individual with daily living activities and movement. Caregivers provide assistance with food and psychological support and ensure that the individual is comfortable.[14]

The patient's family may have questions and most caregivers can provide information to help ease the mind. Doctors generally do not provide estimates for fear of instilling false hopes or obliterate an individual's hope.[15]

In most cases, the caregiver works along with physicians and follows professional instructions. Caregivers may call the physician or a nurse if the individual:

  • experiences excessive pain.
  • is in distress or having difficulty breathing.
  • has difficulty passing urine or is constipated.
  • has fallen and appears hurt.
  • is depressed and wants to harm themselves.
  • refuses to take prescribed medications, raising ethical concerns best addressed by a person with more extensive formal training.
  • or if the caregiver does not know how to handle the situation.

Most caregivers become the patient's listeners and let the individual express fears and concerns without judgment. Caregivers reassure the patient and honor all advance directives. Caregivers respect the individual's need for privacy and usually hold all information confidential.[16][17]

Palliative care

Palliative care focuses on addressing patients' needs after disease diagnosis. While palliative care is not disease treatment, it addresses patients' physical needs, such as pain management, offers emotional support, caring for the patient psychologically and spiritually, and helps patients build support systems that can help them get through difficult times. Palliative care can also help patients make decisions and come to understand what they want regarding their treatment goals and quality of life.[18]

Palliative care has been proven to improve patients' quality-of-life and satisfaction and also help family members cope with their loved one's disease. Additionally, it lowers hospital admissions costs. However, needs for palliative care are often unmet whether due to lack of government support and also possible stigma associated with palliative care. For these reasons, the World Health Assembly recommends development of palliative care in health care systems.[2]

Palliative care and hospice care are often confused, and they have similar goals. However, hospice care is specifically for terminal patients while palliative care is more general and offered to patients who are not necessarily terminal.[19][18]

Hospice care

While hospitals focus on treating the disease, hospices focus on improving patient quality-of-life until death. A common misconception is that hospice care hastens death because patients "give up" fighting the disease. However, patients in hospice care often live the same length of time as patients in the hospital. A study of 3850 liver cancer patients found that patients who received hospice care, and those who did not, survived for the same amount of time. In fact, a study of 3399 adult lung cancer patients showed that patients who received hospice care actually survived longer than those who did not. Additionally, in both of these studies, patients receiving hospice care had significantly lower healthcare expenditures.[20][21]

Hospice care allows patients to spend more time with family and friends. Since patients are in the company of other hospice patients, they have an additional support network and can learn to cope together. Hospice patients are also able to live at peace away from a hospital setting; they may live at home with a hospice provider or at an inpatient hospice facility.[18]

Medications for terminal patients

Terminal patients experiencing pain, especially cancer-related pain, are often prescribed opioids to relieve suffering. The specific medication prescribed, however, will differ depending on severity of pain and disease status.[22]

There exist inequities in availability of opioids to terminal patients, especially in countries where opioid access is limited.[2]

A common symptom that many terminal patients experience is dyspnea, or difficulty with breathing. To ease this symptom, doctors may also prescribe opioids to patients. Some studies suggest that oral opioids may help with breathlessness. However, due to lack of consistent reliable evidence, it is currently unclear whether they truly work for this purpose.[23]

Depending on the patient's condition, other medications will be prescribed accordingly. For example, if patients develop depression, antidepressants will be prescribed. Anti-inflammation and anti-nausea medications may also be prescribed.[24]

Continued treatment

Some terminal patients opt to continue extensive treatments in hope of a miracle cure, whether by participating in experimental treatments and clinical trials or seeking more intense treatment for the disease. Rather than to "give up fighting," patients spend thousands more dollars to try to prolong life by a few more months. What these patients often do give up, however, is quality of life at the end of life by undergoing intense and often uncomfortable treatment. A meta-analysis of 34 studies including 11,326 patients from 11 countries found that less than half of all terminal patients correctly understood their disease prognosis, or the course of their disease and likeliness of survival. This could influence patients to pursue unnecessary treatment for the disease due to unrealistic expectations.[18][25]

Physician-assisted suicide

Physician-assisted suicide (PAS) is a highly controversial concept, only legal in a few countries. In PAS, physicians, with voluntary written and verbal consent from the patient, give patients the means to die, usually through lethal drugs. The patient then chooses to "die with dignity," deciding on his/her own time and place to die. Reasons as to why patients choose PAS differ. Factors that may play into a patient's decision include future disability and suffering, lack of control over death, impact on family, healthcare costs, insurance coverage, personal beliefs, religious beliefs, and much more.[3]

PAS may be referred to in many different ways, such as aid in dying, assisted dying, death with dignity, and many more. These often depend on the organization and the stance they take on the issue. In this section of the article, it will be referred to as PAS for the sake of consistency with the pre-existing Wikipedia page: Assisted Suicide.

In the United States, PAS or medical aid in dying is legal in select states, including Oregon, Washington, Montana, Vermont, and New Mexico, and there are groups both in favor of and against legalization.[26]

Some groups favor PAS because they do not believe they will have control over their pain, because they believe they will be a burden on their family, and because they do not want to lose autonomy and control over their own lives among other reasons. They believe that allowing PAS is an act of compassion.[27]

While some groups believe in personal choice over death, others raise concerns regarding insurance policies and potential for abuse. According to Sulmasy et al., the major non-religious arguments against physician-assisted suicide are quoted as follows:

  • (1) “it offends me,” suicide devalues human life;
  • (2) slippery slope, the limits on euthanasia gradually erode;
  • (3) “pain can be alleviated,” palliative care and modern therapeutics more and more adequately manage pain;
  • (4) physician integrity and patient trust, participating in suicide violates the integrity of the physician and undermines the trust patients place in physicians to heal and not to harm"[28]

Again, there are also arguments that there are enough protections in the law that the slippery slope is avoided. For example, the Death with Dignity Act in Oregon includes waiting periods, multiple requests for lethal drugs, a psychiatric evaluation in the case of possible depression influencing decisions, and the patient personally swallowing the pills to ensure voluntary decision.[29]

Physicians and medical professionals also have disagreeing views on PAS. Some groups, such as the American College of Physicians (ACP), the American Medical Association (AMA), the World Health Organization, American Nurses Association, Hospice Nurses Association, American Psychiatric Association, and more have issued position statements against its legalization.[30][27][31]

The ACP's argument concerns the nature of the doctor-patient relationship and the tenets of the medical profession. They state that instead of using PAS to control death: "through high-quality care, effective communication, compassionate support, and the right resources, physicians can help patients control many aspects of how they live out life's last chapter."[27]

Other groups such as the American Medical Students Association, the American Public Health Association, the American Medical Women's Association, and more support PAS as an act of compassion for the suffering patient.[26]

In many cases, the argument on PAS is also tied to proper palliative care. The International Association for Hospice and Palliative Care issued a position statement arguing against considering legalizing PAS unless comprehensive palliative care systems in the country were in place. It could be argued that with proper palliative care, the patient would experience fewer intolerable symptoms, physical or emotional, and would not choose death over these symptoms. Palliative care would also ensure that patients receive proper information about their disease prognosis as not to make decisions about PAS without complete and careful consideration.[32]

Medical care

Many aspects of medical care are different for terminal patients compared to patients in the hospital for other reasons.

Doctor-patient relationships

Doctor-patient relationships are crucial in any medical setting, and especially so for terminal patients. There must be an inherent trust in the doctor to provide the best possible care for the patient. In the case of terminal illness, there is often ambiguity in communication with the patient about his/her condition. While terminal condition prognosis is often a grave matter, doctors do not wish to quash all hope, for it could unnecessarily harm the patient's mental state and have unintended consequences. However, being overly optimistic about outcomes can leave patients and families devastated when negative results arise, as is often the case with terminal illness.[25]

Mortality predictions

Often, a patient is considered terminally ill when his or her estimated life expectancy is six months or less, under the assumption that the disease will run its normal course based on previous data from other patients. The six-month standard is arbitrary, and best available estimates of longevity may be incorrect. Though a given patient may properly be considered terminal, this is not a guarantee that the patient will die within six months. Similarly, a patient with a slowly progressing disease, such as AIDS, may not be considered terminally ill if the best estimate of longevity is greater than six months. However, this does not guarantee that the patient will not die unexpectedly early.[33]

In general, physicians slightly overestimate the survival time of terminally ill cancer patients, so that, for example, a person who is expected to live for about six weeks would likely die around four weeks.[34]

A recent systematic review on palliative patients in general, rather than specifically cancer patients, states the following: "Accuracy of categorical estimates in this systematic review ranged from 23% up to 78% and continuous estimates over-predicted actual survival by, potentially, a factor of two." There was no evidence that any specific type of clinician was better at making these predictions.[35]

Healthcare spending

Healthcare during the last year of life is costly, especially for patients who used hospital services often during end-of-life.[36]

In fact, according to Langton et al., there were "exponential increases in service use and costs as death approached."[37]

Many dying terminal patients are also brought to the emergency department (ED) at the end of life when treatment is no longer beneficial, raising costs and using limited space in the ED.[38]

While there are often claims about "disproportionate" spending of money and resources on end-of-life patients, data have not proven this type of correlation.[39]

The cost of healthcare for end-of-life patients is 13% of annual healthcare spending in the U.S. However, of the group of patients with the highest healthcare spending, end-of-life patients only made up 11% of these people, meaning the most expensive spending is not made up mostly of terminal patients.[40]

Many recent studies have shown that palliative care and hospice options as an alternative are much less expensive for end-of-life patients.[20][21][19]

Psychological impact

Coping with impending death is a hard topic to digest universally. Patients may experience grief, fear, loneliness, depression, and anxiety among many other possible responses. Terminal illness can also lend patients to become more prone to psychological illness such as depression and anxiety disorders. Insomnia is a common symptom of these.[4]

It is important for loved ones to show their support for the patient during these times and to listen to his or her concerns.[41]

People who are terminally ill may not always come to accept their impending death. For example, a person who finds strength in denial may never reach a point of acceptance or accommodation and may react negatively to any statement that threatens this defense mechanism.[41]

Impact on patient

Depression is relatively common among terminal patients, and the prevalence increases as patients become sicker. Depression causes quality of life to go down, and a sizable portion of patients who request assisted suicide are depressed. These negative emotions may be heightened by lack of sleep and pain as well. Depression can be treated with antidepressants and/or therapy, but doctors often do not realize the extent of terminal patients' depression.[4]

Because depression is common among terminal patients, the American College of Physicians recommends regular assessments for depression for this population and appropriate prescription of antidepressants.[6]

Anxiety disorders are also relatively common for terminal patients as they face their mortality. Patients may feel distressed when thinking about what the future may hold, especially when considering the future of their families as well. It is important to note, however, that some palliative medications may facilitate anxiety.[4]

Coping for patients

Caregivers may listen to the concerns of terminal patients to help them reflect on their emotions. Different forms of psychotherapy and psychosocial intervention, which can be offered with palliative care, may also help patients think about and overcome their feelings. According to Block, "most terminally ill patients benefit from an approach that combines emotional support, flexibility, appreciation of the patient’s strengths, a warm and genuine relationship with the therapist, elements of life-review, and exploration of fears and concerns."[4]

Impact on family

Terminal patients' families often also suffer psychological consequences. If not well equipped to face the reality of their loved one's illness, family members may develop depressive symptoms and even have increased mortality. Taking care of sick family members may also cause stress, grief, and worry. Additionally, financial burden from medical treatment may be a source of stress.[2]

Coping for family

Discussing the anticipated loss and planning for the future may help family members accept and prepare for the patient's death. Interventions may also be offered for anticipatory grief. In the case of more serious consequences such as Depression, a more serious intervention or therapy is recommended.[17]

Grief counseling and grief therapy may also be recommended for family members after a loved one's death.[42]


When dying, patients often worry about their quality of life towards the end, including emotional and physical suffering.[3]

In order for families and doctors to understand clearly what the patient wants for himself or herself, it is recommended that patients, doctors, and families all convene and discuss the patient's decisions before the patient becomes unable to decide.[5][6][43]

Advance directives

At the end of life, especially when patients are unable to make decisions on their own regarding treatment, it is often up to family members and doctors to decide what they believe the patients would have wanted regarding their deaths, which is a heavy burden and hard for family members to predict. An estimated 25% of American adults have an advanced directive, meaning the majority of Americans leave these decisions to be made by family, which can lead to conflict and guilt. Although it may be a difficult subject to broach, it is important to discuss the patient's plans for how far to continue treatment should they become unable to decide. This must be done while the patient is still able to make the decisions, and takes the form of an advance directive. The advance directive should be updated regularly as the patient's condition changes so as to reflect the patient's wishes.[44][17]

Some of the decisions that advance directives may address include receiving fluids and nutrition support, getting blood transfusions, receiving antibiotics, resuscitation (if the heart stops beating), and intubation (if the patient stops breathing).[42]

Having an advance directive can improve end-of-life care.[43]

It is highly recommended by many research studies and meta-analyses for patients to discuss and create an advance directive with their doctors and families.[5][43][6]


One of the options of care that patients may discuss with their families and medical providers is the do-not-resuscitate (DNR) order. This means that if the patient's heart stops, CPR and other methods to bring back heartbeat would not be performed. This is the patient's choice to make and can depend on a variety of reasons, whether based on personal beliefs or medical concerns. DNR orders are medically and legally binding.[45]

Decisions like these should be indicated in the advance directive so that the patient's wishes can be carried out to improve end-of-life care.[44]

Symptoms near death

A variety of symptoms become more apparent when a patient is nearing death. Recognizing these symptoms and knowing what will come may help family members prepare.[42]

During the final few weeks, symptoms will vary largely depending on the patient's disease. During the final hours, patients usually will reject food and water and will also sleep more, choosing not to interact with those around them. Their bodies may behave more irregularly, with changes in breathing, sometimes with longer pauses between breaths, irregular heart rate, low blood pressure, and coldness in the extremities. It is important to note, however, that symptoms will vary per patient.[46]

Good death

Patients, healthcare workers, and recently bereaved family members often describe a "good death" in terms of effective choices made in a few areas:[47]

  • Assurance of effective pain and symptom management.
  • Education about death and its aftermath, especially as it relates to decision-making.
  • Completion of any significant goals, such as resolving past conflicts.[7]

In the last hours of life, palliative sedation may be recommended by a doctor or requested by the patient to ease the symptoms of death until he or she passes away. Palliative sedation is not intended to prolong life or hasten death; it is merely meant to relieve symptoms.[48]

See also


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Further reading

  • "Letting Go" by Atul Gawande (link)
  • "Last Days of Life" for cancer patients provided by the National Cancer Institute (link)
  • "Living with a terminal illness" by Marie Curie (link)
1940 Auckland West by-election

The Auckland West by-election of 1940 was a by-election for the electorate of Auckland West held on 18 May 1940 during the 26th New Zealand Parliament. The by-election resulted from the death on 27 March 1940 of the previous member Michael Joseph Savage, the revered prime minister whose terminal illness had not been made public.

Assisted suicide

Assisted suicide is suicide undertaken with the aid of another person. The term refers to physician-assisted suicide (PAS), which is suicide that is assisted by a physician or other healthcare provider. Once it is determined that the person's situation qualifies under the assisted suicide laws for that place, the physician's assistance is usually limited to writing a prescription for a lethal dose of drugs.

In many jurisdictions helping a person die by suicide is a crime. People who support legalizing assisted suicide want the people who assist in a voluntary suicide to be exempt from criminal prosecution for manslaughter or similar crimes. Assisted suicide is legal in some countries, under certain circumstances, including Canada, Belgium, the Netherlands, Luxembourg, Colombia, Switzerland, and parts of the United States and Australia. In most of those countries, to qualify for legal assistance, people who want to use the assisted-suicide model to die must meet certain criteria, including having a terminal illness, proving they are of sound mind, voluntarily and repeatedly expressing their wish to die, and taking a specified, lethal dose of drugs themselves.

Cabinet of President Goodluck Jonathan

The Cabinet of President Goodluck Jonathan was appointed by Acting President Goodluck Jonathan of Nigeria a few weeks after he took office during the terminal illness of President Umaru Yar'Adua.

Catherine Healy (chef)

Catherine Healy (née Strong) (born Kells, died 1993) was an Irish Michelin star winning head chef during her spell in the kitchen of restaurant Dunderry Lodge.According to the Irish Independent, she may have been Ireland's greatest female chef.She, and her husband Nick, sold the restaurant in 1990, due to a terminal illness.

Chronic condition

A chronic condition is a human health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term chronic is often applied when the course of the disease lasts for more than three months. Common chronic diseases include arthritis, asthma, cancer, chronic obstructive pulmonary disease, diabetes and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome. An illness which is lifelong because it ends in death is a terminal illness.

In medicine, a chronic condition can be distinguished from one that is acute (recent in onset); additionally, a recurrent condition can relapse repeatedly, with periods of remission in between.

The non-communicable diseases are also usually lasting medical conditions but are distinguished by their non-infectious causes. In contrast, some chronic diseases, such as HIV/AIDS, are caused by transmissible infections.

In the United States 25% of adults have at least two chronic conditions. Chronic diseases constitute a major cause of mortality, and the World Health Organization (WHO) attributes 38 million deaths a year to non-communicable diseases.

Death with Dignity National Center

Death with Dignity National Center is a 501(c)(3) nonpartisan nonprofit organization, headquartered in Portland, Oregon, that has led the legal defense of and education about Death with Dignity laws throughout the United States for 20 years. The Death with Dignity National Center helped write and defend in courts the nation's first successful assisted dying law, the Oregon Death with Dignity Act, protecting the right of persons with terminal illness to control their own death. The Death with Dignity National Center is affiliated with the Death with Dignity Political Fund, a distinct and separately incorporated 501(c)(4) organization responsible for the promotion of death with dignity legislation in other states around the U.S.

Dunderry Lodge

Dunderry Lodge is a restaurant in Dunderry, Navan, County Meath, Ireland. It was a fine dining restaurant that was awarded one Michelin star in the period 1986-1989. The Michelin Guide awarded the restaurant the "Red M", indicating 'good food at a reasonable price', in the period 1981-1985. The Egon Ronay Guide awarded the restaurant one star in the period 1983-1985 and 1987-1988.During the time the restaurant was awarded the Michelin star, head chef was Catherine Healy.The restaurant was owned by Nick and Catherine Healy. They sold the restaurant in 1990, due a terminal illness of Catherine.

Helen's Trust

Helen's Trust is a non-profit organization located in Derbyshire, England in the United Kingdom. It aims to enable people with any terminal illness to have the choice to stay in their own home. Originally established in Baslow, the charity now supports people throughout north Derbyshire and Sheffield, providing a help at recipients homes. The organization supports those in need with home care respite, equipment acquisitions, household chores, and additional tasks needed to support those with terminal illness to stay at home.

Kübler-Ross model

The Kübler-Ross model is popularly known as the five stages of grief. Even though it has been represented in modern culture as model of depression, the model was originally designed to postulate a progression of emotional states experienced by terminally ill patients after diagnosis. The five stages are chronologically: denial, anger, bargaining, depression and acceptance.

The model was first introduced by Swiss-American psychiatrist Elisabeth Kübler-Ross in her 1969 book On Death and Dying, and was inspired by her work with terminally ill patients. Motivated by the lack of instruction in medical schools on the subject of death and dying, Kübler-Ross examined death and those faced with it at the University of Chicago medical school. Kübler-Ross' project evolved into a series of seminars which, along with patient interviews and previous research, became the foundation for her book. Although Kübler-Ross is commonly credited with creating stage models, earlier bereavement theorists and clinicians such as Erich Lindemann, Collin Murray Parkes, and John Bowlby used similar models of stages of phases as early as the 1940s.Later in her life, Kübler-Ross noted that the stages are not a linear and predictable progression and that she regretted writing them in a way that was misunderstood. "Kübler-Ross originally saw these stages as reflecting how people cope with illness and dying," observed grief researcher Kenneth J. Doka, "not as reflections of how people grieve."


Noah Raymond Brickley (born February 10, 1978), better known by his stage name Noah23, is a Canadian-American hip hop artist from Guelph, Ontario. He is co-founder of the Plague Language collective and record label, and has been described as "one of Canada's best, most underrated MCs".

Philippe Léotard

Philippe Léotard (Ange Philippe Paul André Léotard-Tomasi; 28 August 1940 – 25 August 2001) was a French actor, poet, and singer.

He was born in Nice, one of seven children - four girls, then three boys, of which he was the oldest - and was the brother of politician François Léotard. His childhood was normal except for an illness (rheumatic fever) which struck him and forced him to spend days in bed during which time he read a great many books. He was particularly fond of the poets - Baudelaire, Rimbaud, Lautréamont, Blaise Cendrars. He met Ariane Mnouchkine at the Sorbonne and in 1964 they formed the théâtre du soleil.

He played Philippe, the tormented son of a woman with terminal illness, in the 1974 drama film La Gueule ouverte, by the controversial director Maurice Pialat. He won a César Award for Best Actor for his role in the 1982 movie La Balance.

One of his few English-language roles was a cameo in the 1973 thriller The Day of the Jackal and he co-starred as "Jacques" in the 1975 John Frankenheimer movie French Connection II which starred Gene Hackman and Fernando Rey, (sequel to The French Connection).

Léotard died in 2001 of respiratory failure in Paris at the age of 60. He was interred at the Montparnasse Cemetery in Paris.

Psychedelic therapy

Psychedelic therapy refers to therapeutic practices involving psychedelic drugs, oftentimes utilizing serotonergic psychedelics such as LSD, psilocybin, DMT, MDMA, mescaline, and 2C-B. Psychedelic therapy, in contrast to conventional psychiatric medication taken by the patient regularly or as-needed, patients generally remain in an extended psychotherapy session during the acute psychedelic activity with additional sessions both before and after in order to help integrate experiences with the drug.

Right of Way (film)

Right of Way is a 1983 American made-for-television drama film written by Richard Lees and starring Bette Davis and James Stewart, and directed by George Schaefer. The film was originally broadcast on HBO on November 21, 1983.

The TV movie stars film veterans Davis and Stewart as an elderly long-married couple who must decide how to deal with the situation of one of them being diagnosed with a terminal illness. Melinda Dillon and Priscilla Morrill also star.

Right to die

The right to die is a concept based on the opinion that a human being is entitled to end their life or to undergo voluntary euthanasia. Possession of this right is often understood that a person with a terminal illness, or without the will to continue living, should be allowed to end their own life, use assisted suicide, or to decline life-prolonging treatment. The question of whom, if anyone, should be empowered to make this decision is often central to the debate.

Some academics and philosophers, such as David Benatar, consider humans to be overly optimistic in their view of the quality of their lives, and their view of the balance between the positive and the negative aspects of living. This idea can be considered in terms of antinatalism and the lack of agency regarding one’s birth and who should have authority over one’s choice to live or die.

Proponents typically associate the right to die with the idea that one's body and one's life are one's own, to dispose of as one sees fit. However, a legitimate state interest in preventing irrational suicides is often argued. Pilpel and Amsel wrote: Contemporary proponents of "rational suicide" or the "right to die" usually demand by "rationality" that the decision to kill oneself be both the autonomous choice of the agent (i.e., not due to the physician or the family pressuring them to "do the right thing" and commit suicide) and a "best option under the circumstances" choice desired by the stoics or utilitarians, as well as other natural conditions such as the choice being stable, not an impulsive decision, not due to mental illness, achieved after due deliberation, etc.Hinduism accepts the right to die for those who are tormented by terminal diseases or those who have no desire, no ambition or no responsibilities remaining. Death is permitted by non-violent means such as fasting to the point of starvation (Prayopavesa). Jainism has a similar practice named Santhara. Other religious views on suicide vary in their tolerance and include denial of the right as well as condemnation of the act. In the Catholic faith, suicide is considered a grave sin.

Signal to Noise (comics)

Signal to Noise (ISBN 1-56971-144-5) is a graphic novel written by Neil Gaiman and illustrated by Dave McKean. It was originally serialised in the UK style magazine The Face, beginning in 1989, and collected as a graphic novel in 1992, published by Victor Gollancz Ltd in the UK and by Dark Horse Comics in the US.The story examines the relationship between images of an imagined World Apocalypse and the experience of one man's personal, individual apocalypse. In it a film-maker learns he is suffering from a terminal illness, and imagines a last film which he will never have time to make before he dies.

There have been two adaptations of the graphic novel into other media: in 1996, Gaiman adapted his own story for a BBC radio broadcast, with music by McKean; and in 1999, a stage adaptation written by Marc Rosenbush and Robert Toombs was mounted in Chicago with Gaiman's cooperation.

Terminal illness insurance

Terminal Illness Insurance (known as Accelerated Death benefit in North America) pays out a capital sum if the policyholder is diagnosed with a terminal illness from which the policyholder is expected to die within 12 months of diagnosis, by a physician who specialises in that illness or condition.

Terminal Illness Insurance is a form of insurance that is often added to a life insurance policy or a Mortgage Life Insurance policy by the insurance company issuing the policy. Terminal Illness Insurance is not available as a separate insurance policy.

If a life insurance policyholder also has terminal illness insurance, then he/she has the benefit of knowing that if he/she is diagnosed with a serious illness and is expected to die within 12 months of diagnosis, then the combined policy will pay out straight away rather than waiting for the policyholder to die (as would happen if the policyholder did not have terminal illness insurance).

Do not confuse terminal illness insurance with critical illness insurance. The two forms of insurance are very different.

The Last Best Year

The Last Best Year is a 1990 American made-for-television drama film starring Mary Tyler Moore and Bernadette Peters concerning a lonely woman who discovers that she has a terminal illness. It originally premiered on ABC on November 4, 1990.

The Mouth Agape

The Mouth Agape (French: La gueule ouverte) is a 1974 French drama film directed by Maurice Pialat. It depicts, in a cinematic realist fashion, a woman going through a terminal illness and also dealing with the tumorous lives of her husband and son. It was one of the least commercially successful of Pialat's films. It was the third film of the ten that he directed before his death in January 2003. It is also known under the titles The Gaping Mouth and The Gaping Maw.

The film stars Monique Mélinand, Philippe Léotard, Hubert Deschamps, and Nathalie Baye in the main roles. Néstor Almendros, the Spanish cinematographer known for working with the Nouvelle Vague directors François Truffaut and Éric Rohmer, collaborated with Pialat for the first time on The Mouth Agape. The title is a poetic reference to the open mouth position sometimes found in corpses.

In medicine
After death

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