Timothy E. Quill

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Timothy E. Quill is an American physician specialising in palliative care at the University of Rochester Medical Center in Rochester, New York. He is also a board member of the Death with Dignity National Center in Portland, Oregon. Quill was the lead plaintiff in a case that eventually reached the Supreme Court of the United States in 1997, Vacco v. Quill , in which the Court decided that a state law against physician-assisted suicide was constitutional. [1]

Quill earned his undergraduate degree from Amherst College in 1971, and his M.D. from the University of Rochester School of Medicine and Dentistry in 1976. [2]

In 1991, Quill published an article in The New England Journal of Medicine [3] describing how he assisted in the suicide of Patricia Diane Trumbull, [4] a 45-year-old leukemia patient referred to in the article as "Diane". The report describes how Patricia, a long-time patient of Quill's with an extensive medical history including vaginal cancer, alcoholism and other issues was diagnosed with leukemia but refused chemotherapy. She shortly thereafter decided that she wanted to kill herself rather than have a "lingering death" which doctors had told her may be a matter of weeks or months away. Quill describes in the article how he referred her to the Hemlock Society and a week later she requested barbiturates to help with "insomnia". He gave her a prescription and told her the amount required to treat both insomnia and the dose required to bring about death. Some time after getting the prescription, she said her final goodbyes to Quill and her family and took the barbiturates alone. Patricia's husband reported the death to Quill who reported the cause of death as acute leukemia but left off mention of the suicide in reporting it to the medical examiner. When interviewed by the New York Times in 1991, Quill stated that he had not helped anyone else to die before or since. [5] No charges or indictments were brought against Quill. The publication of this story has been considered to have "made history" [6] and to have "stunned the medical community". [7]

Quill has subsequently been active in arguing for legalization of physician-assisted suicide, including during the controversial trials of Jack Kevorkian, [8] and regarding the case of Terri Schiavo. [9] Quill has argued against the principle of double effect in bioethics. [10]

In 2013, the American Academy of Hospice and Palliative Medicine included Quill on a list of 'Hospice and Palliative Medicine Visionaries'. [11]

Related Research Articles

<span class="mw-page-title-main">Assisted suicide</span> Suicide undertaken with aid from another person

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

Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual." In the past, palliative care was a disease specific approach, but today the WHO takes a broader approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness.

The right to die is a concept based on the opinion that human beings are entitled to end their life or undergo voluntary euthanasia. Possession of this right is often understood that a person with a terminal illness, incurable pain, 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 who, if anyone, may be empowered to make this decision is often the subject of debate.

<span class="mw-page-title-main">Terri Schiavo case</span> American right-to-die legal case

The Terri Schiavo case was a series of court and legislative actions in the United States from 1998 to 2005, regarding the care of Theresa Marie Schiavo, a woman in an irreversible persistent vegetative state. Schiavo's husband and legal guardian argued that Schiavo would not have wanted prolonged artificial life support without the prospect of recovery, and in 1998 elected to remove her feeding tube. Schiavo's parents disputed her husband's assertions and challenged Schiavo's medical diagnosis, arguing in favor of continuing artificial nutrition and hydration. The highly publicized and prolonged series of legal challenges presented by her parents, which ultimately involved state and federal politicians up to the level of President George W. Bush, caused a seven-year delay before Schiavo's feeding tube was ultimately removed.

In medicine, specifically in end-of-life care, palliative sedation is the palliative practice of relieving distress in a terminally ill person in the last hours or days of a dying person's life, usually by means of a continuous intravenous or subcutaneous infusion of a sedative drug, or by means of a specialized catheter designed to provide comfortable and discreet administration of ongoing medications via the rectal route.

Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced heart disease than for injury. 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 as being 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. An illness which is lifelong but not fatal is a chronic condition.

Pentobarbital is a short-acting barbiturate typically used as a sedative, a preanesthetic, and to control convulsions in emergencies. It can also be used for short-term treatment of insomnia but has been largely replaced by the benzodiazepine family of drugs.

Voluntary euthanasia (VE) is the ending of a person's life at their request in order to relieve them of suffering. Voluntary euthanasia and physician-assisted suicide (PAS) have been the focus of intense debate in recent years.

<span class="mw-page-title-main">Ira Byock</span> American physician and author

Ira Robert Byock is an American physician, author, and advocate for palliative care. He is founder and chief medical officer of the Providence St. Joseph Health Institute for Human Caring in Torrance, California, and holds appointments as active emeritus professor of medicine and professor of community health and family medicine at the Geisel School of Medicine at Dartmouth College. He was director of palliative medicine at Dartmouth–Hitchcock Medical Center, from 2003–14, and associate director for patient and family-centered care at the affiliated Norris-Cotton Cancer Center.

Euthanasia is currently illegal in all 50 states of the United States. Assisted suicide is legal in 10 jurisdictions in the US: Washington, D.C. and the states of California, Colorado, Oregon, Vermont, New Mexico, Maine, New Jersey, Hawaii, and Washington. The status of assisted suicide is disputed in Montana, though currently authorized per the Montana Supreme Court's ruling in Baxter v. Montana that "nothing in Montana Supreme Court precedent or Montana statutes [indicates] that physician aid in dying is against public policy."

End-of-life care refers to health care provided in the time leading up to a person's death. End-of-life care can be provided in the hours, days, or months before a person dies and encompasses care and support for a person's mental and emotional needs, physical comfort, spiritual needs, and practical tasks.

<span class="mw-page-title-main">Kathryn Tucker</span>

Kathryn Tucker is an American attorney and the executive director of the End of Life Liberty Project, which she founded during her tenure as executive director of the Disability Rights Legal Center. This appointment to the DRLC was opposed by every other major disability rights group and has since been terminated. She graduated from Georgetown University Law Center in 1985 and Hampshire College in 1981. Tucker has been an adjunct law professor at Lewis and Clark School of Law, Seattle University the University of Washington, Loyola/LA and Hastings. Beginning in 1990, while an attorney at the Seattle firm of Perkins Coie, she did pro bono work for Washington Citizens for Death with Dignity, which led her into the movement to legalize physician assisted suicide.

<span class="mw-page-title-main">Washington Death with Dignity Act</span> Ballot measure in Washington legalizing some assisted suicide

Initiative 1000 (I-1000) of 2008 established the U.S. state of Washington's Death with Dignity Act, which legalizes medical aid in dying with certain restrictions. Passage of this initiative made Washington the second U.S. state to permit some terminally ill patients to determine the time of their own death. The effort was headed by former Governor Booth Gardner.

<span class="mw-page-title-main">Hospice care in the United States</span>

In the United States, hospice care is a type and philosophy of end-of-life care which focuses on the palliation of a terminally ill patient's symptoms. These symptoms can be physical, emotional, spiritual or social in nature. The concept of hospice as a place to treat the incurably ill has been evolving since the 11th century. Hospice care was introduced to the United States in the 1970s in response to the work of Cicely Saunders in the United Kingdom. This part of health care has expanded as people face a variety of issues with terminal illness. In the United States, it is distinguished by extensive use of volunteers and a greater emphasis on the patient's psychological needs in coming to terms with dying.

Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by reducing pain and suffering. Hospice care provides an alternative to therapies focused on life-prolonging measures that may be arduous, likely to cause more symptoms, or are not aligned with a person's goals.

Euthanasia became legal in New Zealand when the End of Life Choice Act 2019 took full effect on 7 November 2021. It is illegal to "aid and abet suicide" under Section 179 of the New Zealand Crimes Act 1961. The clauses of this act make it an offence to "incite, procure or counsel" and "aid and abet" someone else to commit suicide, regardless of whether a suicide attempt is made or not. Section 179 covers both coercion to undertake assisted suicide and true suicide, such as that caused by bullying. This will not change under the End of Life Choices Act 2019, which has provisions on coercion of terminally ill people.

<span class="mw-page-title-main">Assisted suicide in the United States</span> Medically-induced suicide with help from another person

Assisted suicide is suicide with the aid of another person. In the United States, the term "assisted suicide" is typically used to describe what proponents refer to as medical aid in dying, in which terminally ill adults are prescribed and self-administer barbiturates if they feel that they are suffering significantly. The term is often used interchangeably with physician-assisted suicide (PAS), "physician-assisted dying", "physician-assisted death", "assisted death" and "medical aid in dying" (MAiD).

<i>Baxter v. Montana</i> Montana Supreme Court decision ruling physician-assisted dying is not illegal

Baxter v. Montana, is a Montana Supreme Court case, argued on September 2, 2009, and decided on December 31, 2009, that addressed the question of whether the state's constitution guaranteed terminally ill patients a right to lethal prescription medication from their physicians. The Montana Supreme Court sidestepped the question of if medical aid in dying is guaranteed under Montana State Constitution, but it instead ruled, on narrower grounds, that neither legal precedent nor the state's statute deem such assistance to be against public policy or illegal. Montana is one of ten states in which aid in dying is authorized. The others are California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Oregon, Vermont, and Washington; it is authorized in the District of Columbia as well.

Terminal dehydration is dehydration to the point of death. Some scholars make a distinction between "terminal dehydration" and "termination by dehydration". Courts in the United States generally do not recognize prisoners as having a right to die by voluntary dehydration, since they view it as suicide.

<span class="mw-page-title-main">Harvey Chochinov</span> Canadian academic and psychiatrist

Harvey Max Chochinov is a Canadian academic and psychiatrist from Winnipeg, Canada. He is a leading authority on the emotional dimensions of end-of-life, and on supportive and palliative care. He is a Distinguished Professor of Psychiatry at the University of Manitoba and a Senior Scientist at CancerCare Manitoba Research Institute.

References

  1. "Dr Timothy E. Quill: Making choices about the end of your life". Southern Methodist University. Retrieved 7 November 2011.
  2. "Timothy E. Quill, M.D." (profile). University of Rochester School of Medicine and Dentistry.
  3. Quill, T. E. (1991). "Death and Dignity". New England Journal of Medicine. 324 (10): 691–694. doi:10.1056/NEJM199103073241010. PMID   1994255. S2CID   57823235.
  4. Gross, Jane (2 January 1997). "Quiet Doctor Finds a Mission in Assisted Suicide Court Case". New York Times. Retrieved 7 November 2011.
  5. Altman, Lawrence K. (7 March 1991). "Doctor Says He Gave Patient Drug to Help Her Commit Suicide". New York Times. Retrieved 7 November 2011.
  6. Gross, Jane (10 November 2008). "Landscape Evolves for Assisted Suicide". New York Times. Retrieved 7 November 2011.
  7. Connelly, R. J. (1998). "Death with Dignity: Fifty Years of Soul-Searching". Journal of Religion and Health. 37 (3): 195–213. doi:10.1023/A:1022981721537. PMID   11657109. S2CID   1179572.
  8. "Interview with Timothy Quill, M.D." PBS. Retrieved 7 November 2011.
  9. Quill, Timothy E. (April 2005). "Terri Schiavo — A Tragedy Compounded". New England Journal of Medicine. 352 (16): 1630–1633. doi:10.1056/NEJMp058062. PMID   15784658.
  10. "Critique of the Double Effect". NPR All Things Considered. Retrieved 7 November 2011.
  11. "AAHPM Honors Hospice and Palliative Medicine Visionaries". American Academy of Hospice and Palliative Medicine. 2013. Retrieved 26 February 2014.