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October 22, 2006

The NYTimes, letters, and end-of-life care

So, I've been writing letters to the editor to the NYTimes for years. And they have never printed any of them. Until I started working for the Anti-Defamation League...and writing them under somebody else's name.Two weeks ago I read the Science Times's feature article on end-of-life care--a really great article, I might add--and was inspired to write a letter under my own name for the first time in a while. I received an e-mail in response indicating they were "considering my letter for publication" and asking me to confirm I had indeed written it. I confirmed...and never heard back. Drat.The cool part about having a blog is that you are the editor (unless Alec and Andrew decide to stage a coup), and so I'm going to go right ahead and print that letter here:The New York TimesTo The Editor:Re “The Last Word on The Last Breath” (Science Times, Oct. 10):Doctors first have the responsibility to provide the best care in their power, which means trying to save any lives that can be saved and providing physical comfort for those that can’t. Absent other orders, then, doctors should perform any and all live-saving treatments until they believe the patient is not savable and then halt any treatments that would induce undue discomfort.Those of us who believe in true individual autonomy also believe that a patient of sound mind—a clear-headed adult—or in the absence, next of kin, can within reason request additional care beyond the physician-deemed point-of-no-return or decreased care before that point is reached. Too little care enters the legal debate of negligence and too much care wastes scarce medical resources.The challenge, then, is finding on this spectrum the right level of care which satisfies patient, family, physician, hospital, and law. The most difficult hurdle will always be deciding what exactly the point-of-no-return is.George L. AnesiNew York, October 10, 2006I'd like to posit that the title of the letter writer has a great deal of influence on whether or not the letter gets printed. That's not necessarily a bad thing, but almost certainly a fact at the Times. On that note, the next letter I send in will be from: George Anesi, Director of the East 53rd Street Bioethics Clinic.