TY - JOUR T1 - On the sanctity of life JF - British Journal of General Practice JO - Br J Gen Pract SP - 332 LP - 333 VL - 57 IS - 537 AU - Michael A Weingarten Y1 - 2007/04/01 UR - http://bjgp.org/content/57/537/332.abstract N2 - It is commonplace to pit the length of life against the quality of life. This happens in the sort of clinical discussion where the patient is nearly dead and seems to have little residual human functioning left. The typical situation GPs may face is the decision whether to send the patient to hospital for vigorous intravenous treatment of pneumonia or urinary infection, or leave them at home to survive or succumb under oral antibiotics alone. The resolution of the quandary generally depends more on the personalities involved than on rational debate. One of the more unfortunate consequences is where the family is called on to decide how energetically the doctors should strive to maintain the waning life. I say this is unfortunate because family members, albeit more familiar with the preferences of the patient, are also more liable to be in a state of conflict of interest, especially where they are the immediate caregivers bearing the personal cost and the day-today burden of the terminal stage of life, and even more so where they are the prospective inheritors of the patient's property.I should like to unpick some of the terms we sometimes use only half-thinking. Underlying the discussion is a concept of a life not worth living, for it is only such a life that may be scrutinised as a candidate for termination, whether by benign neglect, passive euthanasia or assisted suicide. One may distinguish between early, middle and late lives that are not worth living. The early ones, severely damaged neonates, are clearly different from the late ones, the old person with advanced dementia in deep coma who has had what is often called a good and long innings. But it is the ones in the middle that are … ER -