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Dr. Berkey Replies

To the Editor: I thank Dr. Kal for responding to my essay. My metaphorical use of the life and death of Hsing-Hsing was intended to reflect my deeply held views that we, as physicians and psychiatrists, must go beyond talking about compassion for the hopelessly ill. Thoughtfully confronting end-of-life issues is merely the first step; I feel we need to set into motion concrete protocols offering help for stricken individuals and their families. Everyone acknowledges the potentially serious abuses of euthanasia and physician-assisted suicide, but at the very least I would like APA to establish itself as a leader among medical groups by publicly expressing a willingness to reach out to the terminally ill and their families about alternatives to pain, helplessness, suffering, and indignity.

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