I was pleased to see Miller and Meier's article on terminal dehydration and physician-assisted suicide [1]. It follows quite nicely the triad of papers on the same subject published in Annals in 1996 [2-4]. At the time, I wrote the editor a letter in which I described my unpleasant experiences with the death of two older sisters whose expressed wishes were cruelly ignored [5].

I have recently gone through the death of my last (and favorite) sister. It was a totally different experience, thanks to more enlightened management of the terminally ill. After a severe bout of facial shingles, my sister's recovery had been slow, but she fought valiantly for a month. When she transferred to a rehabilitation unit, I felt that she had a shot at regaining her strength. My discussion with the competent young man in charge of the rehabilitation unit was very encouraging. At my sister's request, I reviewed the terms of her living will with her and her compassionate charge nurse.

However, it soon became apparent that she was not responding adequately, and she began to reduce her intake of fluid and food. Her nurses complied with her wishes, keeping her comfortable without badgering her. Her physician did not even mention a feeding tube. Over a period of two and a half weeks, she gradually slipped into a coma and died quite peacefully.

There is no doubt in my mind that this was but another manifestation of Joyce Stead's strong will and determination, with which her four siblings had long been familiar. Her voluntary act kept her from having the grossly unpleasant experience that she had seen forced on our two sisters.

It will be of interest to some readers that I first learned of this manner of voluntary death several years ago from the best known of my siblings, Eugene A. Stead Jr., who had wide experience with death as a part-time physician of a nursing home while still working as a professor of medicine at Duke University. His many friends will be glad to know that both Gene and his wife, Evelyn, are still in good health, he in his 90th year. He and I agree that when our times come we shall take a course similar to that chosen by Joyce.